Viral protein R polymorphisms in the pathogenesis of HIV-associated acute ischaemic stroke: a case–control study

ObjectiveRecent anticoagulation trials in all-comer cryptogenic stroke patients have yielded equivocal results, reinvigorating the focus on identifying reproducible markers of an atrial myopathy. We investigated the role of excessive premature atrial complexes (PACs) in ischaemic stroke, including cryptogenic stroke and its association with vascular risk factors.Methods and resultsA case–control study was conducted utilising a multicentre institutional stroke database to compare 461 patients with an ischaemic stroke or transient ischaemic attack (TIA) with a control group consisting of age matched patients without prior history of ischaemic stroke/TIA. All patients underwent 24-hour Holter monitoring during the study period and atrial fibrillation was excluded. An excessive PAC burden, defined as ≥200 PACs/24 hours, was present in 25.6% and 14.7% (p<0.01), of stroke/TIA and control patients, respectively. On multivariate regression, excessive PACs (OR 1.97; 95% CI 1.29 to 3.02; p<0.01), smoking (OR 1.58; 95% CI 1.06 to 2.36; p<0.05) and hypertension (OR 1.53; 95% CI 1.07 to 2.17; p<0.05) were independently associated with ischaemic stroke/TIA. Excessive PACs remained the strongest independent risk factor for the cryptogenic stroke subtype (OR 1.95; 95% CI 1.16 to 3.28; p<0.05). Vascular risk factors that promote atrial remodelling, increasing age (≥75 years, OR 3.64; 95% CI 2.08 to 6.36; p<0.01) and hypertension (OR 1.54; 95% CI 1.01 to 2.34; p<0.05) were independently associated with excessive PACs.ConclusionsExcessive PACs are independently associated with cryptogenic stroke and may be a reproducible marker of atrial myopathy. Prospective studies assessing their utility in guiding stroke prevention strategies may be warranted.

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Clot lysis time and the risk of myocardial infarction and ischaemic stroke in young women; results from the RATIO case-control study

British Journal of Haematology ◽

10.1111/j.1365-2141.2011.08935.x ◽

2011 ◽

Vol 156 (2) ◽

pp. 252-258 ◽

Cited By ~ 13

Author(s):

Bob Siegerink ◽

Mirjam E. Meltzer ◽

Philip G. de Groot ◽

Ale Algra ◽

Ton Lisman ◽

...

Keyword(s):

Myocardial Infarction ◽

Ischaemic Stroke ◽

Young Women ◽

Case Control Study ◽

Case Control ◽

Clot Lysis ◽

Lysis Time ◽

Control Study ◽

Clot Lysis Time ◽

Stroke In Young

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Additive interaction between potentially modifiable risk factors and ethnicity among individuals in the Han, Tujia and Miao populations with first-ever ischaemic stroke

BMC Public Health ◽

10.1186/s12889-021-11115-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Na Zhang ◽

Xinrui Wu ◽

Mengyuan Tian ◽

Xiaolei Wang ◽

Jian Ding ◽

...

Keyword(s):

Risk Factors ◽

Ischaemic Stroke ◽

Ethnic Minorities ◽

Case Control Study ◽

Case Control ◽

Moderate Intensity ◽

Modifiable Risk Factors ◽

Additive Interaction ◽

Han Population ◽

Control Study

Abstract Background As a country with one-fifth of the global population, China has experienced explosive growth in ischaemic stroke (IS) burden with significant ethnic and geographic disparities. The aim of this study was to examine the differences in potentially modifiable risk factors for ischaemic stroke among the Han population and two ethnic minorities (Tujia and Miao). Methods A case-control study was conducted with 324 cases of first-ever ischaemic stroke from the hospitals of the Xiangxi Tujia and Miao Autonomous Prefecture and 394 controls from communities covering the same area between May 1, 2018, and April 30, 2019. Structured questionnaires were administered, and physical examinations were performed in the same manner for cases and controls. Univariate and multivariate logistic regression analyses with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were used to examine the association between risk factors and ischaemic stroke. An additive model was used to study the interaction between the modifiable risk factors and ethnicity with R software. Results Higher high-sensitivity C-reactive protein levels (OR 50.54, 95%CI 29.76–85.85), higher monthly family income (4.18, 2.40–7.28), increased frequency of hot pot consumption (2.90, 1.21–6.93), diabetes mellitus (2.62, 1.48–4.62), a higher apolipoprotein (Apo)B/ApoA1 ratio (2.60, 1.39–4.85), hypertension (2.52, 1.45–4.40) and moderate-intensity physical activity (0.50, 0.28–0.89) were associated with ischaemic stroke. There was an additive interaction between the ApoB/ApoA1 ratio and ethnicity in the Tujia and Miao populations with first-ever ischaemic stroke (the relative excess risk due to the interaction was 5.75, 95% CI 0.58 ~ 10.92; the attributable proportion due to the interaction was 0.65, 95% CI 0.38 ~ 0.91; the synergy index was 3.66, 95% CI 1.35 ~ 9.93). Conclusions This is the first case-control study examining modifiable risk factors for ischaemic stroke among the Han population and two ethnic minorities (Tujia and Miao) in China. Some differences were observed in the impact of risk factors among these ethnic groups. Our results may help interpret health-related data, including surveillance and research, when developing strategies for stroke prevention.

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