Acute ischaemic stroke common among kids with cardiac disease

Acute systemic illnesses or thrombotic events may trigger acute ischaemic stroke (AIS) in children with cardiac disease, a recent study has shown. Many of these events occur beyond the usual periprocedural window.

The study included 627 children (58 percent male) with congenital or acquired cardiac diseases acting as potential primary risk factors for AIS. Periprocedural stroke events were defined as those occurring during or within 72 hours of cardiac intervention procedures. These cases were compared against spontaneous AIS events occurring beyond this time period.

Majority of the participants (74 percent; n=495) had spontaneous AIS; the remaining 177 experienced periprocedural events

The presence of acute systemic illness at the time of AIS was common in the overall cohort but was more so in the spontaneous AIS group (37 percent vs 31 percent; p=0.17).

In comparison, 41 patients were identified to have a prothrombotic state, 34 (7 percent) of whom had spontaneous AIS while seven (4 percent) had periprocedural episodes (p=0.7). Preceding thrombotic events also occurred significantly more commonly in the spontaneous AIS group (16 percent vs 9 percent; p=0.02).

“These findings reflect uncertainties in optimal clinical care for a complicated and heterogeneous group; additional data are required to guide evidence-based management,” said researchers. “Further multicentre prospective studies are needed to determine best the practices for secondary stroke prevention in this vulnerable population.”