Abstract TP109: Multiplicity of Atherosclerotic Risk Factors Predicts a Risk of Large Arterial Atherosclerosis and Long-term Mortality in Patients with Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Sungho Ahn ◽  
Eun-Jae Lee ◽  
Dong-Wha Kang ◽  
Sun U. Kwon ◽  
Jong S. Kim
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Baseline Risk ◽  
Large Artery ◽  
Stroke Patients ◽  
Atherosclerotic Burden ◽  
Point Increase ◽  
Atherosclerotic Risk Factors ◽  
Long Term Mortality

Background: The aim of this study was to investigate clinical significance of multiplicity of atherosclerotic risk factors to determine the type of stroke and long-term mortality in patients with large artery atherosclerotic (LAA) and small vessel occlusive (SVO) stroke. Methods: We retrospectively analyzed medical data of the prospectively registered stroke patients who were diagnosed as LAA and SVO type of ischemic stroke based on diffusion weighted MRI and magnetic resonance angiography between January 2005 and December 2013. Multiplicity of risk factors was defined as numbers of hypertension, diabetes, hyperlipidemia and smoking. Information on mortality as outcome was obtained and reconfirmed from the National Death Certificate system. Results: A total of 4099 patients comprising 2530 LAA stroke and 1569 SVO stroke were studied. After adjustment for differences in baseline risk profiles, multiplicity of risk factors (per 1-point increase, odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.02-1.18) was significantly associated with the LAA stroke than SVO stroke. Among patients with SVO stroke, patients with a higher multiplicity of risk factors had a higher long-term mortality (OR = 1.34, 95% CI = 1.10-1.65) during 8-year of observation. Conclusions: Atherosclerotic burden defined by multiplicity of risk factors for atherosclerosis could predict the probability of developing LAA stroke compared to the SVO stroke, and long-term mortality particularly in SVO stroke.

Abstract 176: Long Term Mortality in Acute Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation According to Location and Burden of Cerebral Microbleeds

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tae-Jin Song ◽  
Jinkwon Kim ◽  
Dongbeom Song ◽  
Yong-Jae Kim ◽  
Hyo Suk Nam ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Independent Predictor ◽  
Stroke Patients ◽  
Risk Of Death ◽  
Long Term Mortality

Background: Cerebral microbleeds (CMBs) were predictive of mortality in elderly and considered as a putative marker for risk of intracranial hemorrhage. Stroke patients with non valvular atrial fibrillation (NVAF) require anticoagulation, which increases the risk of hemorrhages. We investigated association of CMBs with the long term mortality in acute ischemic stroke patients with NVAF. Methods: During 6 years , consecutive ischemic stroke patients who had NVAF and who had undergone brain MRI with a gradient-recalled echo sequence were enrolled. Long-term mortality and causes of death were identified using data from Korean National Statistical Office. Survival analysis was performed whether the presence, number and location of CMBs were related with all causes, cardiovascular, and cerebrovascular mortality during follow-up. Results: Total 506 patients were enrolled during the study period and were followed up for median 2.5 years. CMBs were found in 30.8% of patients (156/506). Oral anticoagulation with warfarin was prescribed at discharge in 477 (82.7%) patients. During follow up, 177 (35%) patients died and cerebrovascular death was noted in 93 patients (81 ischemic stroke and 12 hemorrhagic stroke). After adjusting age, sex and significant variables in univariate analysis (p<0.1), multiple CMBs (≥5) were the independent predictor for all-cause, cardiovascular and ischemic stroke mortalities. The strictly lobar CMBs were associated with hemorrhagic stroke mortality in multivariate Cox regression analysis (HR 4.776, p=0.032) (Figure 1). Conclusions: Multiple CMBs were the independent predictor for the long term mortality in stroke patients with NVAF. Among them, patients with strictly lobar CMBs had a high risk of death due to hemorrhagic stroke. Our findings suggest that detection of CMBs in stroke patients with NVAF are of clinical relevance for predicting long term outcome and that particular concern is necessary in those with strictly lobar CMBs for their increased risk of death due to hemorrhagic stroke. Figure 1.

scholarly journals Ischemic Stroke in Young Adults: Study of the Subtypes, Risk factors and Predictors of Poor Outcomes

2019 ◽  
Vol 16 (1) ◽  
pp. 29-34
Author(s):  
Reema Rajbhandari ◽  
Parmatma Prajuli ◽  
K K Oli
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Small Scale ◽  
Sudden Increase ◽  
Large Artery ◽  
Stroke Patients ◽  
Aggressive Approach ◽  
Positive Correlation ◽  
Poor Outcomes

The aim of this study is to show the subtype, risk factors and predictors of poor outcomes in young ischemic stroke patients. Materials and Methods: It is a prospective study where only young onset ischemic stroke patients are analyzed. 8% of total ischemic stroke sufferers were young adults; more prevalent in female (57.1%), with risk factors of smoking (47.6%) subtype cardio embolic (42.9%) was common. High NIHSS score was related to new event and correlation to mortality. Three month follow up showed MRS 2.86 ± 1.02. 57.1% of cases had significant disability (defined as MRS ≥ 3). There was a positive correlation of the cardio embolic subtype and the unclassified subtype to all three forms of poor outcomes, along with a positive correlation of the large artery atherothrombotic subtype to new events Recurrence of events (new stroke, sudden increase in symptoms and new TIAs) was observed in 14.3 %. Death was reported in 9.5% of cases.   Etiological diagnosis can be reached in majority of cases if an aggressive approach is maintained. This small scale study has provided an overview of the distribution of subtypes, risk factors and poor outcomes and their predictors. Cardiac diseases (esp. valvular disease) need to be taken more seriously to prevent cardio embolic strokes, while addressing other traditional risk factors to prevent the atherothrombotic subtypes.

Long-term mortality among young ischemic stroke patients in western Norway

2007 ◽  
Vol 116 (3) ◽  
pp. 150-156 ◽  
Author(s):  
U. Waje-Andreassen ◽  
H. Naess ◽  
L. Thomassen ◽  
G. E. Eide ◽  
C. A. Vedeler
Keyword(s):  
Ischemic Stroke ◽  
Stroke Patients ◽  
Western Norway ◽  
Young Ischemic Stroke ◽  
Long Term Mortality

scholarly journals Intracranial Atherosclerosis in Stroke Patients, Which Risk Factors Are Important? A Study From Mixed Ethnic Population in Singapore.

2021 ◽  
Author(s):  
shrikant Pande ◽  
May Thiri Lwin ◽  
Aye Aye Khine ◽  
May Win Myat ◽  
Lorecar Lolong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariable Analysis ◽  
Large Artery ◽  
Intracranial Atherosclerosis ◽  
Stroke Patients ◽  
Term Survival ◽  
Significant Stenosis ◽  
Proactive Management ◽  
History Of

Abstract Intracranial atherosclerosis (ICAD) although more common in Asians, has not been studied from Singapore population. The aim of this study is to identify prevalence ICAD in stroke subjects, its association with comorbidities, stroke subtypes and long-term survival. We performed retrospective analysis of 681 stroke patients, 327(48%) had ICAD) with 232 (71%) having one or more intracranial artery with significant stenosis. ICAD was associated with older age, ischaemic strokes, total anterior circulation syndrome (TACS), large artery strokes (p<0.001), peripheral vascular disease (PVD, p=0.018), diabetes mellitus (DM), and with history of hyperlipidemia. In addition, higher serum potassium (p=0.046) and glucose (p<0.001), lower haemoglobin (p=0.040) and aortic valve sclerosis were significantly associated with ICAD (p<0.001). Multivariable analysis showed a significant independent association of ICAD with advancing age, history of hyperlipidemia and DM.In ischemic strokes (489), 311(64%) had ICAD of which 229(72%) had significant stenosis. Of the 192 hemorrhagic strokes, 16 (8%) had ICAD.Conclusion: The prevalence of ICAD, especially in ischemic strokes, from our study is high. As modifiable risk factors such as hyperlipidemia and DM appear to be associated with ICAD, then proactive management of these conditions may improve long term associated complications. Prospective studies may help to validate our findings.

Abstract 2510: Hemodialysis Is A Risk Factor For Short Or Long Term Mortality In Ischemic Stroke Patints.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Takashi Shiromoto ◽  
Kensaku Shibazaki ◽  
Yasuyuki Iguchi ◽  
Junya Aoki ◽  
Jyunichi Uemura ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Mortality Rate ◽  
Stroke Onset ◽  
Basilar Artery Occlusion ◽  
Stroke Patients ◽  
Factors Associated ◽  
Long Term Mortality

Background and purpose Hemodialysis(HD) is reported to be a risk factor for cerebrovascular events and poor prognosis. However, it is unclear whether HD is a risk factor for short or long term mortality in ischemic stroke patients. The aim of the present study was to investigate whether a short or long term mortality of stroke patient s receiving HD is higher than those without HD. Methods From April 2007 to May 2010, we retrospectively enrolled ischemic stroke patients within 24h of stroke onset who admitted to our hospital. We divided patients into two groups according to presence and absence of receiving HD(HD group and non-HD group) . We compared clinical characteristics and the mortality rate at discharge and 1year after stroke onset between the two groups. The factors associated with death were investigated by multivariate logistic regression analysis. Results 687 patients (417 males; (61.4%), mean age 72.4 ± 11 years) were enrolled. 29 patients (4.0%) had HD. HD group was younger(69.8±14.2 vs. 73.0±11.9 year,P<0.001), and hypertension(97%vs. 68%, P<0.001) and basilar artery occlusion(10% vs. 2%, P=0.01) were more frequently observed than non-HD group . In-hospital mortality was 6.7% (46/687 patients). HD group was high mortality rate compared with non HD group(21%vs. 6%, P=0.002). Multivariate logistic regression analysis demonstrated that higher NIHSS score on admission, (OR 1.2, 95% CI 1.109-1.207, P <0.001), basilar artery occlusion (OR 3.6, 95% CI 1.031-12.36, P = 0.05), and HD(OR 7.8, 95%CI 2.259-26.79, P = 0.001) were independent factors associated with in-hospital death. Next, after hospital discharge, 14.5% of patients died within 1 year. HD group was high mortality rate compared with non HD group(50%vs. 13%, P<0.001). On multivariate regression analysis, age per 1year increase(OR 1.0, 95%CI 1.015-1.078, P = 0.03), poor functional outcome (modified Ranking Scale (3-5)) at discharge (OR 2.0, 95%CI 1.635-2.599, P <0.001), and HD(OR 26.4, 95%CI 7.532-92.503, P <0.001) were independent factors associated with death within 1year of stroke onset. Therefore, HD was independently associated with short or long term mortality. Conclusions; HD is a risk factor for short or long term mortality in ischemic stroke patients.

scholarly journals Outcome Predictors in First-Ever Ischemic Stroke Patients: A Population-Based Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Giovanni Corso ◽  
Edo Bottacchi ◽  
Piera Tosi ◽  
Laura Caligiana ◽  
Chiara Lia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Old Age ◽  
Population Based ◽  
Stroke Severity ◽  
Very Old ◽  
Very Old Age ◽  
Long Term Mortality

Background. There is scant population-based information regarding predictors of stroke severity and long-term mortality for first-ever ischemic strokes. The aims of this study were to determine the characteristics of patients who initially presented with first-ever ischemic stroke and to identify predictors of severity and long-term mortality. Methods. Data were collected from the population-based Cerebrovascular Aosta Registry. Between 2004 and 2008, 1057 patients with first-ever ischemic stroke were included. Variables analysed included comorbidities, sociodemographic factors, prior-to-stroke risk factors, therapy at admission and pathophysiologic and metabolic factors. Multivariate logistic regression models, Kaplan-Meier estimates, and Cox proportional Hazards model were used to assess predictors. Results. Predictors of stroke severity at admission were very old age (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.75–5.06), female gender (OR 1.73, 95% CI 1.21–2.40), atrial fibrillation (OR 2.76, 95% CI 1.72–4.44), low ejection fraction (OR 2.22, CI 95% 1.13–4.32), and cardioembolism (OR 2.0, 95% CI 1.36–2.93). Predictors of long-term mortality were very old age (hazard ratio [HR] 2.02, 95% CI 1.65–2.47), prestroke modified Rankin scale 3–5 (HR 1.82; 95% CI 1.46–2.26), Charlson Index ≥2 (HR 1.97; 95% CI 1.62–2.42), atrial fibrillation (HR 1.43, 95% CI 1.04–1.98), and stroke severity (HR 3.54, 95% CI 2.87–4.36). Conclusions. Very old age and cardiac embolism risk factors are the independent predictors of stroke severity. Moreover, these factors associated with other comorbid medical conditions influence independently long-term mortality after ischemic stroke.

scholarly journals Risk Factors and Etiology of Young Ischemic Stroke Patients in Estonia

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Siim Schneider ◽  
Alina Kornejeva ◽  
Riina Vibo ◽  
Janika Kõrv
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Age Groups ◽  
Young Patients ◽  
Substantial Part ◽  
Large Artery ◽  
Stroke Patients ◽  
Young Stroke ◽  
First Time

Objectives. Reports on young patients with ischemic stroke from Eastern Europe have been scarce. This study aimed to assess risk factors and etiology of first-ever and recurrent stroke among young Estonian patients. Methods. We performed a retrospective study of consecutive ischemic stroke patients aged 18–54 years who were treated in our two hospitals from 2003 to 2012. Results. We identified 741 patients with first-ever stroke and 96 patients with recurrent stroke. Among first-time patients, men predominated in all age groups. The prevalence of well-documented risk factors in first-time stroke patients was 83% and in the recurrent group 91%. The most frequent risk factors were hypertension (53%), dyslipidemia (46%), and smoking (35%). Recurrent stroke patients had fewer less well-documented risk factors compared to first-time stroke patients (19.8 versus 30.0%, P=0.036). Atrial fibrillation was the most common cause of cardioembolic strokes (48%) and large-artery atherosclerosis (LAA) was the cause in 8% among those aged <35 years. Compared to first-time strokes, recurrent ones were more frequently caused by LAA (14.3 versus 24.0%, P=0.01) and less often by other definite etiology (8.5 versus 1.0%, P=0.01). Conclusions. The prevalence of vascular risk factors among Estonian young stroke patients is high. Premature atherosclerosis is a cause in a substantial part of very young stroke patients.

scholarly journals Risk Factors and Etiologies of Ischemic Stroke in Young Adults: A Hospital-based Study in Bangladesh

2018 ◽  
Vol 8 (2) ◽  
pp. 138-144
Author(s):  
Rumana Habib ◽  
Ikram Hosen ◽  
Rashedul Islam ◽  
Nirmalendu Bikash Bhowmik
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Internal Capsule ◽  
Large Artery ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Stroke In Young Adults ◽  
Subcortical Region ◽  
Associated Risk Factors

Background: Stroke is an important cause of disability among adults and is one of the leading causes of death worldwide. Strokes in young adults can have a significant impact on the affected individuals, their families and societies in general as the affected patients are in the economically productive period of their lives.This study was aimed to find out the demographic profile and explore the associated risk factors of the first-ever ischemic stroke of young adults.Methods: This retrospective study reviewed the records of 64 patients, age 18-49 years, ischemic stroke patients consecutively admitted in the Neurology department, BIRDEM General Hospital during the period January 2016 to June 2017. Study variables included hematological and biochemistry investigations and radiological and imaging findings. Stroke sub-typing was done following to TOAST criteria. Data of follow-up data at 3 month were also included. Data were expressed as number (percent) and managed by SPSS for Windows Version 15.Results: Of the 634 patients diagnosed as acute ischemic stroke 64 (9.90%) were in the 18-49 (yr) age range and the majority (55.4%) were male. Stroke was more common (47 out of 54) among the 31-49 years category as compare with the <30 years category. Stroke patients presented with diabetes mellitus(87.03%),arterial hypertension (44.4%), dyslipidemia (23.5%) and cigarette smoking (31.48%). Family history of stroke was present in 33.5% cases. Ten (6.51%) patients showed hypercoagualable state.Small vessel occlusion (SVO) found in 48.40% cases followed by large artery atherosclerosis (21.86%).Patients with SVO stroke presented with lacunar syndromes and lesions in Basal ganglia(12.1%),Thalamus(6.6%), Subcortical region (0.9%),Internal capsule (20.0%)and brain stem(11.3%). Thrombolysis was not done in any of patients. Most of the patients were on an anti-platelet treatment and majority (85.4%) receiving aspirin alone. Strokes left 48(75.5%)patients with moderate to moderately severe disability on discharge from the hospital.Mortality was lower (6.3%) and had good recovery 35 (54.6%).Conclusion: Ischemic stroke in the young adults accounted for 9.90% of the hospital admission with stroke. Those suffered from ischemic stroke had presence of modifiable risk factors. Predominance of SVO among them not only indicated stroke etiology but also predicted good short term prognosis.Birdem Med J 2018; 8(2): 138-144

Sign in / Sign up

Export Citation Format

Share Document