Global survey of the diagnostic evaluation and management of cryptogenic XXXX .

@entity1 @entity64 @entity385 @entity63
BACKGROUND: About 25% of @entity63 strokes are categorized as cryptogenic (i.e. of unknown cause), but few data exist about the extent of diagnostic testing or treatment. We undertook an international survey to characterize current diagnostic evaluation and antithrombotic management of @entity1 with cryptogenic @entity385 in 2014. AIMS/HYPOTHESIS: To determine the type of diagnostic evaluation undertaken for cryptogenic @entity385 and antithrombotic management and to compare across global regions. METHODS: An 18-question online survey was sent to 995 physicians involved in @entity64 care in 61 countries. Countries were separated into World Bank global regions and income groups. Diagnostic tests were considered routine if performed in >75% of @entity1 at a center. RESULTS: Three hundred one completed surveys were received from 48 countries (response rate    30%). The majority (82%) of hospitals were from high-income countries and mainly from Europe and Central Asia (56%) and North America (19%). For @entity385 @entity1 , magnetic resonance imaging is routinely obtained at 36% of hospitals (highest in North America, 58%). Among cryptogenic @entity64 @entity1 , transesophageal echocardiography is routinely performed in 17% of hospitals. More than 24   hour cardiac rhythm monitoring is done routinely at relatively few (17%) hospitals (highest in North America, 33%). Intracranial arterial imaging is done routinely at 70% of hospitals, with no significant regional differences. Antiplatelet therapies are routinely prescribed for secondary prevention at 94% of hospitals. CONCLUSIONS: Based on self-selected respondents from a large number of international @entity64 centers, transesophageal echocardiography and prolonged (>24   h) cardiac rhythm monitoring are not routinely performed in cryptogenic @entity64 @entity1 , even in high-income countries. Antiplatelet therapy is the global standard for secondary prevention of cryptogenic @entity64 .
