Reply from the Author

Reply from the Authors: We thank Drs. Lee, Lodder, Hart, and colleagues for their interest in our recent article. A few comments, however, seem pertinent for its best comprehension.

Our article breaks new ground by analyzing the interactions between death, stroke severity, and hemorrhagic complications, using the most appropriate statistical methods available. Apparently, our critics based their arguments on two main points: (1) The low recurrence rate of embolic stroke, and (2) the mortality rate due to hemorrhagic complications.

First, on the low recurrence rate of embolic stroke, estimated by some authors to be approximate 2 to 4%. ^[2,4] However, it must be noted that other series have reported a greater risk or recurrent embolic stroke. ^[10,14] Lodder et al. ^[10] estimated a risk greater than 8%, and Halperin and Hart, ^[9] estimated a 15% to 20% stroke recurrence rate within the first year alone. More recently, Yasaka et al ^[12] found recurrent embolization within the first 2 weeks after stroke to be 20.3% and the recurrent events most frequently occurred during the first 2 days after the initial stroke. In addition, mortality in patients who recurred was 19.6% compared with 8.8% in patients with no stroke recurrences. Also, Darling et al ^[13] reported the rate of recurrent thromboembolism within 14 days to be 19.6% in 148 patients with valvular and NVAF, and …