The evolution of Clinical, Electrocardiographic, Echocardiographic profile and in patient outcomes among patients admitted for Acute Cardioembolic Stroke at a Tertiary Hospital in the Philippines: A two years study
2nd International Conference on Central Nervous System and Therapeutics
June 10-11, 2019 | Edinburgh, Scotland
Jose Eduardo DL Duya
Philippine General Hospital, Philippines
Scientific Tracks Abstracts : J Neurol Neurorehabil Res
Abstract:
Background/ Introduction: One of 5 ischemic strokes
is cardioembolic in nature. Despite the robust data on
cardioembolic stroke (CES) in western literature, there is
scarcity of local data on Asians. Higher prevalence of rheumatic
heart disease (RHD) in developing countries and the growing
availability of NOACs may contribute to an evolving patient
profile. This study aims to define the profile, management
and in hospital acute outcomes of Filipino patients with CES.
Methods: A 2-year retrospective study of patients with CES
admitted at UP-PGH. Data were obtained through review of
records using a standardized data collection form. 126 patients
were enrolled. Mean age was 59.9 years. Majority (88%) had
a CHADS-VASC Score of >2. Atrial fibrillation remains the most
common rhythm abnormality (67%) and 20% has RHD (mitral
stenosis). On echo, 92% had LVH and 58% had left atrial
enlargement. Interestingly, only 5% had thrombus and merely
8% had rheologic stasis. Majority had moderate-large artery
territory infarctions with 40% hemorrhagic conversion within
4 days. Two of 3 patients were given initial anticoagulation.
Only half of those who survived were discharged on oral
anticoagulation. Only 10% of patients were given NOACs.
Mean HASBLED score was 1.9 ± 0.96. Bleeding complications
was 6%. CES were associated with longer hospital stay (16
days) and development of nosocomial pneumonia(46%).
DISCUSSION: strong> To our knowledge this is the largest Filipino
cohort with CES reported in local literature. The profile of
Filipino CES patients was similar to the previous international
studies in terms of the patients’ age, neuroimaging findings,
rate of hemorrhagic conversion, and low anticoagulation rate.
Contrary to western data, what is interesting is that Filipino
CES patients are younger, with majority of them having RHD
in contrast to degenerative causes in the western world.
Prompt and adequate management of RHD is important to
prevent CES.
Biography:
Jose Eduardo Duya earned his Bachelor of Science in Public Health degree from the University of the Philippines Manila in 2005, finishing Class Valedictorian, cum laude. He obtained his Doctor of Medicine degree from the UP College of Medicine in 2010 where he finished First Honorable Mention, cum laude. At a young age, he discovered his passion for Internal Medicine and pursued a straight internship program in Internal Medicine at the UP Philippine General Hospital. He finished his training in Internal Medicine from the same institution in 2013 where he received numerous awards in various inter-hospital competitions and was further named Most Outstanding Internal Medicine Resident for three consecutive years. In 2013, he was named as one of the Most Outstanding Residents in Training by the Philippine College of Physicians. He was elected President of the PGH Physicians’ Association in 2011-2013 and the Assistant Chief Resident for Undergraduate Training during his senior year. He pursued his passion in Cardiology as his subspecialty in the same institution where he served as a Chief Fellow and eventually became one of the 10 outstanding performers in the Specialty Board Exam of Adult Cardiology in 2017. He fatefully became the PHA Most outstanding Cardiology Fellow in 2017. Presently, he is a Diplomate and Fellow of the Philippine College of Physicians and the Philippine Heart Association, Philippine College of Cardiology. Armed with beaming determination, due diligence, unwavering willingness to learn and a healthy competitive spirit, he aims to inspire others by being a good example. His vision is to be able to empower and create effective leaders from students/trainees, and peers achieving their full potential through transformative leadership, mentoring and stewardship. His personal advocacies include advancement of medical education, public health service, women empowerment, gender sensitivity awareness and advocating and adopting healthier life style changes. Amidst all these, Joey is a well rounded and multi-talented guy gifted with extra-ordinary artistic, teaching and hosting skills.
E-mail: joeyduya@gmail.com
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