scholarly journals Moterų insulto rizikos veiksniai ir jų įtaka miego arterijos endarterektomijos rezultatams

2005 ◽  
Vol 3 (2) ◽  
pp. 0-0
Author(s):  
Auksė Meškauskienė ◽  
Egidijus Barkauskas ◽  
Virginija Gaigalaitė ◽  
Kęstutis Laurikėnas
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Sex Differences ◽  
Carotid Endarterectomy ◽  
Stroke Risk ◽  
Study Cohort ◽  
Complication Rates ◽  
Surgical Risk ◽  
Stroke Risk Factors ◽  
History Of

Auksė Meškauskienė, Egidijus Barkauskas, Virginija Gaigalaitė, Kęstutis LaurikėnasVilniaus universiteto Neurologijos ir neurochirurgijos klinikosNeuroangiochirurgijos centras,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Įvadas / tikslas Literatūroje pateikiama prieštaringų duomenų apie miego arterijos endarterektomijos operacinę riziką moterims, palyginti su vyrais. Mes išanalizavome moterų ir vyrų tradicinius insulto rizikos veiksnius ir jų prognozinę reikšmę miego arterijos endarterektomijos rezultatams. Ligoniai ir metodai Išanalizavome Vilniaus greitosios pagalbos universitetinėje ligoninėje 1995–2003 m. operuotų nuo miego arterijos stenozės ligonių duomenis ir palyginome insulto rizikos veiksnius, gretutines ligas bei operacinę mirties, insulto ir miokardo infarkto riziką priklausomai nuo lyties. Naudojomės logistinės regresijos metodu, kad nustatytume moterų ir vyrų chirurginę riziką pagal amžių ir kitus insulto rizikos veiksnius. Rezultatai Ištyrėme 129 moterų ir 373 vyrų duomenis. Moterys, palyginti su vyrais, buvo vyresnio amžiaus, dažniau sirgo arterine hipertenzija, daugiau buvo nutukusių ir turėjo padidėjusį cholesterolio kiekį, bet mažiau rūkė. Arterinė hipertenzija ir hipercholesterolemija buvo dažniausiai pasitaikantys moterų insulto rizikos veiksniai. Moterų sergamumas vainikine širdies liga, periferinių arterijų obliteruojančia ateroskleroze, cukriniu diabetu statistiškai reikšmingai nesiskyrė nuo vyrų. Moterų operacinių komplikacijų buvo mažiau nei vyrų, tačiau skirtumas nebuvo statistiškai reikšmingas (mirčių – 2,3% vs 3,5%; operacinių insultų – 0,8% vs 2,1%; miokardo infarktų – 1,5% vs 1,9%, visais atvejais p > 0,05), o tradiciniai insulto rizikos veiksniai turėjo mažai įtakos komplikacijoms pasireikšti. Didžiausia operacinių komplikacijų tikimybė nustatyta moterims, sergančioms cukriniu diabetu (ŠS 7,43; 95% PI 1,7–17,8, p < 0,002). Išvados Moterų miego arterijos endarterektomijos komplikacijų skaičius nebuvo didesnis nei vyrų ir neviršijo 6 procentų nustatytos ribos, kai išnyksta operacinio gydymo pranašumas medikamentinio atžvilgiu. Cukrinis diabetas yra potencialus moterų galimų operacinių komplikacijų rizikos veiksnys. Reikšminiai žodžiai: insulto rizikos veiksniai, miego arterijos endarterektomija, moterys, komplikacijų rizika Stroke risk factors and their impact on the surgical risk of carotid endarterectomy in women Auksė Meškauskienė, Egidijus Barkauskas, Virginija Gaigalaitė, Kęstutis LaurikėnasVilnius University, Clinic of Neurology and Neurosurgery,Center of Neurovascular Surgery,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Background / objective The literature provides conflicting evidence regarding surgical risks of carotid endarterectomy in women as compared to men. We used data from our carotid surgery registry to determine whether sex differences exist in the stroke risk factors and their impact on the surgical risk of carotid endarterectomy. Patients and methods We have analyzed data on all patients operated on for carotid artery stenosis at the Vilnius Emergency Hospital in 1995–2003 and have compared gender-dependent stroke risk factors, concomitant diseases and the perioperative risks of death, sroke and myocardical infarction. The logistic regression method was employed to determine the surgical risk in men and women depending on age and other risks of stroke. Results The study cohort consisted of 129 women and 373 men. Women were older than men, more likely to have a history of hypertension; they were more obese, had higher levels of cholesterol and less of them smoked. There were no significant sex differences in the history of coronary artery disease, diabetes mellitus and peripheral vascular disease. The incidence of death, stroke and myocardial infarction in women was even slightly lower than in men (2.3% versus 3.5%; 0.8% versus 2.1%; 1.5% versus 1,9%, all p > 0,05). Diabetes mellitus (OR odds ratio 7.43; 95% CI 1.7 to 17.8, p < 0.002) was predictive of a higher surgical risk in women. Conclusions Operative complication rates from carotid endarterectomy in women were not worse than in men and did not exceed the recommended upper limits for operative risk, confirming the beneficial effects of carotid endarterectomy in women. Diabetes mellitus was a potential prognostic factor for a higher surgical risk in women. Keywords: stroke risk factors, carotid endarterectomy, women, surgical risk

Abstract NS6: Family History of Stroke: Invisibility of a Key Stroke Risk Factor among High Risk African Americans

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Dawn M Aycock ◽  
Kenya D Kirkendoll ◽  
Kisha C Coleman ◽  
Karen C Albright ◽  
Anne W Alexandrov
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Perceived Control ◽  
Stroke Risk ◽  
Perceived Threat ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
History Of ◽  
Physiologic Data

Background & Purpose: Young to middle aged African Americans (AA) are at greater risk for a first-ever stroke, severe neurologic disability, and stroke-related mortality, than Caucasians of similar age; however, it remains unclear what role a family history of stroke (FHS) plays in promoting adoption of healthier lifestyles in this cohort. The purpose of this study was to explore differences between rural Stroke Belt AA with a FHS (e.g. parent/grandparent/sibling) on modifiable stroke risk factors, knowledge, perceived threat and perceived control of stroke, and exercise behaviors to AA without a FHS. Methods: A cross-sectional study was conducted recruiting AA aged 19-54 from the Black Belt region of Alabama via a mobile health clinic. Participants’ perceptions, knowledge, exercise history/intent, physiologic data, and health history were recorded. Results: Participants (N=66) averaged 43.3+9.4 years, were 71% female, with at least 12 years of school (89%), and unemployed (62%). Common risk factors were insufficient exercise (76%), obesity (59%), hypertension (53%; blood pressure M=145+17.6/88.3+12.9), and cigarette smoking (38%). Participants with a FHS (n=33) did not differ on average number of risk factors compared to those without a FHS (FHS 2.8+1.4 vs. 2.2+1.5; t(64)= 1.73, p=.089), nor did they differ on physiologic data. However, participants with a FHS were more likely to report a history of hypertension (67%) compared to those without a FHS (33%; χ2 =4.93, p <.05). There were no significant differences between groups for knowledge of stroke risk factors, perceived threat and perceived control of stroke, or recent exercise performance, although participants with a FHS (3.4+1.2) had significantly lower future intentions to exercise compared to those without a FHS (3.9+0.8); t(64)=2.45, p<.05). Conclusions: Although FHS is a significant non-modifiable risk factor for stroke and was common in this young to middle-aged AA cohort, FHS did not drive perceived stroke risk, risk factor control, or current/future intentions to exercise. Identification of interventions designed to personalize FHS as a key stroke risk factor, while promoting lifestyle change and self-management, may play an important role in future primary stroke prevention.

scholarly journals Prevalence of Stroke Risk Factors and Their Distribution Based on Stroke Subtypes in Gorgan: A Retrospective Hospital-Based Study—2015-2016

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Mahdi Habibi-koolaee ◽  
Leila Shahmoradi ◽  
Sharareh R. Niakan Kalhori ◽  
Hossein Ghannadan ◽  
Erfan Younesi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
Stroke Risk ◽  
Healthcare Providers ◽  
Age Groups ◽  
University Hospital ◽  
Stroke Registry ◽  
Stroke Risk Factors ◽  
Stroke Subtypes

Background. Stroke is a leading cause of death and disability worldwide. According to the Iranian Ministry of Medical Health and Education, out of 100,000 stroke incidents in the country, 25,000 lead to death. Thus, identifying risk factors of stroke can help healthcare providers to establish prevention strategies. This study was conducted to investigate the prevalence of stroke risk factors and their distribution based on stroke subtypes in Sayad Shirazi Hospital, Gorgan, Northeastern Iran. Material and Methods. A retrospective hospital-based study was conducted at Sayad Shirazi Hospital in Gorgan, the only referral university hospital for stroke patients in Gorgan city. All medical records with a diagnosis of stroke were identified based on the International Classification of Diseases, Revision 10, from August 23, 2015, to August 22, 2016. A valid and reliable data gathering form was used to capture data about demographics, diagnostics, lifestyle, risk factors, and medical history. Results. Out of 375 cases, two-thirds were marked with ischemic stroke with mean ages (standard deviation) of 66.4 (14.2) for men and 64.6 (14.2) for women. The relationship between stroke subtypes and age groups (P=0.008) and hospital outcome (P=0.0001) was significant. Multiple regression analysis showed that hypertension (Exp. (B) =1.755, P=0.037), diabetes mellitus (Exp. (B) =0.532, P=0.021), and dyslipidemia (Exp. (B) =2.325, P=0.004) significantly increased the risk of ischemic stroke. Conclusion. Overall, hypertension, diabetes mellitus, and dyslipidemia were the major risk factors of stroke in Gorgan. Establishment of stroke registry (population- or hospital-based) for the province is recommended.

Relationship Between Stroke’s Risk Factors with Daily Activities Using Modified Shah Barthel Index in Chronic Stroke Patient at RSCM

2018 ◽  
Vol 24 (8) ◽  
pp. 6225-6231
Author(s):  
S Rachmayanti ◽  
W Kusumaningsih
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Logistic Regression ◽  
Stroke Risk ◽  
Chronic Stroke ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Chi Square ◽  
Stroke Risk Factors ◽  
The Relationship

Hypertension and diabetes mellitus are the most common risk factors of stroke.The study aimed to determine the relationship between stroke risk factors, hypertension and diabetes mellitus, with dependency of chronic stroke patients in Department of Medical Rehabilitation RSCM. The study is conducted by using the analytical observational cross-sectional study. The samples used in this study were 44 respondents selected by quota sampling method. The relationship between variabels was analyzed by bivariate test Chi-Square and multivariate analysis: Logistic Regression. Based on Chi-Square test, relationship between MSBI scoring with hypertension and diabetes mellitus as stroke risk factors, sequentiallly p = 0,122 and p = 0,002. Furthermore, Logistic Regression test suggested that hypertension and diabetes mellitus as stroke risk factors related to MSBI scoring, respectively; hypertension p = 0,076 (OR 4,076; CI95 0,861–19,297) and diabetes mellitus p = 0,007 (OR 22,690; CI95 2,332–220,722). Discussion: Diabetes mellitus is the most prominent risk factor in severe dependecy of chronic stroke patients.

scholarly journals The Risk of Stroke Using CHA2 DS2 -VASc Score in Hemodialysis Patients at a Tertiary Hospital in Riyadh, Saudi Arabia

2019 ◽  
Vol 4 (7) ◽  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Stroke Risk ◽  
Hemodialysis Patients ◽  
Low Risk ◽  
High Risk Patients ◽  
Stroke Risk Factors ◽  
Increased Risk ◽  
Risk Patients ◽  
History Of

Introduction: Patients undergoing hemodialysis are at increased risk of stroke. However, less known about the impact of some of the stroke risk factors, and the value of stroke risk scores in determining the risk in those patients. Our main goal. To assess the risk factors for stroke in hemodialysis patients and the use of the new CHA2DS2-VASc score for stroke assessment. Methods: Single center, retrospective cohort study of 336 patients undergoing hemodialysis from June 24, 2018, to September 6, 2018, was recruited. Baseline demographics, clinical, and laboratory data were collected. We calculated the CHA2 DS2 -VASc score for stroke assessment in all patients and categorized them into high, moderate and low risk patients according to CHA2 DS2 - VASc score and subcategorized them to two groups atrial fibrillation (AFib) and Non- Atrial fibrillation (Non AFib) patients. Results: 336 patients were included in our study; the majority of patients were at high risk with a CHA2 DS2 -VASc Score mean of 2.9± 1.5, although history of stroke was observed only in 15 patients (4.46%). According to CHA2 DS2 - VASc score, 280 patients were at high risk, 172 (51.19%) were high-risk patients on treatment (anticoagulant or antiplatelet) and 108(32.14%) patients were high risk patients not on treatment 48 were at moderate risk (14.28%) and 8 were at low risk (2.38 %). Patients were divided into subgroups as non-AFib and AFib. In non-AFib patients 320 (95.23%), high-risk patients 103 (32.18%) were not treated; high-risk patients with treatment are 162 (50.62%), moderate patients were 47 (14.68%), 8(2.5%) was in low risk. AFib patients were 16 with a mean CHA2 DS2 -VASc score of 4.4±1.1. Patients with AFib were all at high risk except 1 was at moderate risk (6.25%). There were 11 (68.75%) patients on treatment and 5 (31.25%) patients not on treatment. The risk factors for stroke that were statistically significant in increasing score risk for all patients were: age > 65 (95% CI, -2.04– -1.29; p = 0.000), being female (95% CI, -1.36– -0.68; p = 0.000) hypertension (95% CI, -2.59– -1.37; p = 0.000), diabetes (95% CI, -2.10– -1.50; p = 0.000), CVD (95% CI, -2.07– -1.24; p=0.000), history of stroke or TIA (95% CI, -3.70– -2.03; p = 0.000), CHF or LVEF (95% CI, -2.28– - 0.91; p = 0.000). Conclusions: The risk of stroke in hemodialysis patients is significant according to the use of CHA2 DS2 -VASc score in Non-AFib hemodialysis patients shows supportive evidence of increased risk of stroke in those patients, which suggest the importance of close monitoring of patients with stroke risk factors by the nephrologist and the stroke team which will lead to the initiation of early prophylaxis in those patients.

scholarly journals PROFIL FAKTOR-FAKTOR RISIKO PADA PASIEN STROKE YANG DIRAWAT INAP DI IRINA F NEUROLOGI RSUP PROF. Dr. R. D. KANDOU MANADO PERIODE JANUARI – OKTOBER 2012

e-CliniC ◽  
2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Rio Christanto ◽  
Corry N. Mahama ◽  
Melke J. Tumboimbela
Keyword(s):  
Risk Factors ◽  
Stroke Risk ◽  
Risk Category ◽  
Stroke Patients ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
History Of ◽  
Male Sex ◽  
Acute Attacks ◽  
Diabetes Melitus

Abstract: Stroke is a serious neurological disease, with acute attacks that can lead to death. Closely related to the occurrence of stroke risk factors possessed by the patient, especially if there are risk factors that are not addressed properly. Aim: To know the profile of risk factors in stroke patients hospitalized in neurology. irina F  of  RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Methods: The study descriptive with retrospective method is to collect all the data of patients who had been diagnosed with stroke in inpatient neurology irina F RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Results: The results showed that the highest percentage of stroke patients are in the age group 51-65 years (45.2%), male sex (51.2%), high risk category of hypertension (92.2%), risk category Low dyslipidemia ((73.1%), low risk of diabetes mellitus (83.8%), history of heart problems (40.2%), had a history of smoking (8.2%). Conclusion: There are three factors that influence the risk of stroke incidence is age, gender and hypertension Keywords: stroke, risk factors Abstrak: Stroke merupakan penyakit neurologi yang serius, dengan serangan akut yang dapat menyebabkan kematian. Terjadinya stroke berkaitan erat dengan faktor risiko yang dipunyai oleh penderita, terutama bila faktor risiko yang ada tidak ditanggulangi dengan baik. Tujuan: Mengetahui profil faktor-faktor risiko pada pasien stroke yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai oktober 2012. Metode: Penelitian deskriktif  dengan metode retrospektif yaitu mengumpulkan semua data penderita yang telah didiagnosa dengan stroke  yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai Oktober 2012.  Hasil: Hasil penelitian menunjukan bahwa persentase terbanyak pasien stroke berada pada golongan umur 51-65 tahun (45,2%), berjenis kelamin laki-laki (51,2%), kategori risiko tinggi hipertensi (92,2%), kategori risiko rendah dislipidemia ((73,1%), risiko rendah diabetes melitus (83,8%), riwayat atau kelainan jantung (40,2%), memiliki riwayat merokok (8,2%). Simpulan: Terdapat 3 faktor risiko yang berpengaruh terhadap kejadian stroke yaitu umur, jenis kelamin dan hipertensi Kata kunci: Stroke, faktor risiko

Stroke in CT-scan Department of Khartoum Hospital, Sudan

2007 ◽  
Vol 37 (4) ◽  
pp. 244-245 ◽  
Author(s):  
Ahmed M El Zein ◽  
Elfateh A Bukhari ◽  
Susan Homeida ◽  
Ishag Adam
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Computed Tomography ◽  
Clinical Characteristics ◽  
Stroke Risk ◽  
Haemorrhagic Stroke ◽  
Computed Tomography Scan ◽  
Prospective Data ◽  
Stroke Risk Factors ◽  
Tomography Scan

Prospective data were collected on consecutive patients admitted to Khartoum Teaching Hospital with a diagnosis of stroke. Risk factors and clinical characteristics were assessed by neurological examination and computed tomography scan. A total of 128 patients were enrolled in the study, of whom 74 (57.8%) were men. The age (mean±standard deviation) of the patients was 53±18.5 years. Eighty-five (66.4%) and 43 (33.6%) patients had ischaemic and haemorrhagic stroke, respectively. Hypertension, diabetes mellitus, smoking, heart disease and hypercholesterolaemia were the risk factors for stroke. Thus, further studies are needed on stroke. Hypertension should be discovered early and treated effectively.

Pro-neurotensin/neuromedin N and risk of ischemic stroke: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study

2020 ◽  
Vol 25 (6) ◽  
pp. 534-540
Author(s):  
Charles D Nicoli ◽  
Nicholas Wettersten ◽  
Suzanne E Judd ◽  
George Howard ◽  
Virginia J Howard ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
Racial Differences ◽  
Stroke Risk ◽  
Cox Proportional Hazards Model ◽  
Demographic Model ◽  
Stroke Risk Factors ◽  
Regards Study ◽  
Neuromedin N

The tridecapeptide neurotensin has been implicated in the pathogenesis of cardiometabolic disease. Its stable precursor, pro-neurotensin/neuromedin N (pro-NT/NMN), has been associated with composite cardiovascular outcomes including coronary heart disease (CHD) and stroke. The exclusive association of pro-NT/NMN with ischemic stroke has not been evaluated. We conducted a prospective case-cohort study in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. From 2003 to 2007, REGARDS enrolled 30,239 white or black adults aged ⩾ 45 years. Baseline fasting pro-NT/NMN was measured by immunoassay in the analytic sample including 448 incident ischemic stroke cases and 818 random cohort sample participants. A total of 464 ischemic strokes occurred. Risk of stroke was assessed with a Cox proportional-hazards model incorporating demographic covariates and a second adding stroke risk factors. Increased pro-NT/NMN was associated with ischemic stroke in the demographic model overall (hazard ratio (HR) per standard deviation (SD) pro-NT/NMN 1.16, 95% confidence interval (CI) 1.01–1.33) and in men (HR per SD pro-NT/NMN 1.25, 95% CI 1.04–1.50); HRs were attenuated in the risk factor model. Pre-existing diabetes mellitus and CHD were the largest confounders of ischemic stroke risk, each accounting for an estimated 19% of the association of pro-NT/NMN with ischemic stroke observed in the demographic model. There were no significant interactions of race or sex with pro-NT/NMN. Further research on associations of pro-NT/NMN with stroke risk factors such as diabetes mellitus is indicated.

scholarly journals Knowledge of stroke risk factors among the patients with previous stroke or transient ischemic attack in a tertiary care hospital of Bangladesh

2020 ◽  
Vol 11 (1) ◽  
pp. 22-29
Author(s):  
Md Rashedul Islam ◽  
Tanbin Rahman ◽  
Rafi Nazrul Islam ◽  
Mohammad Sakhawat Hossen Khan ◽  
Mofizul Islam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Carotid Stenosis ◽  
Analysis Of Variance ◽  
Stroke Risk ◽  
Categorical Variables ◽  
Care Hospital ◽  
Stroke Risk Factors ◽  
Previous Stroke ◽  
History Of

Background: Patients of stroke or transient ischaemic attacks (TIA) are at risk of further stroke. Our objective was to study patients admitted with stroke/TIA regarding their knowledge about risk factors for having anew event of stroke/TIA, possible associations between patient characteristics and patients’ knowledge about risk factors, and patients’ knowledge about their preventive treatment for stroke/TIA. Methods: A questionnaire was used for 200 patients with stroke/TIA diagnoses. We asked 13 questions about diseases/conditions and lifestyle factors known to be risk factors and four questions regarding other diseases/ conditions (“distractors”). Additional questions concerned with the patients’ social and functional status and their drug use were asked. Categorical variables were analyzed using chi square test, while one-way analysis of variance and univariate analysis of variance were used for continuous variables. Logistic regression was employed to describe risk. A p value of, p < 0.05 was considered statistically significant. Results: The risk factors that were most often identified by the patients were Diabetes(75.9%), hypertension(83.3%), previous stroke or TIA(81.5%), smoking (85.2%), regular exercise(75.9%), older age(83.3%), overweight (75.9%) and patients with ischemic heart disease (70.4%). Atrial fibrillation and carotid stenosis were identified by less than 50% of the patients. 44.5% of the patients could identify 10 or more stroke/TIA risk factors. We observed that higher age, having a diagnosis of cerebral infarction/TIA, patients residing in urban area, high income group, businessman/retired service holder, family history of cardiovascular disease, past history of stroke / TIA were related to better knowledge of stroke/TIA risk factors. Anticoagulants and antiplatelets are important drugs for stroke/TIA prevention but only 20(9.3%) of the patients who reported anticoagulants and 76(35.2%) of the patients taking these drugs marked them as intended for prevention. Conclusion: Knowledge about diabetes, hypertension and smoking as risk factors was good, and patients who suffered from atrial fibrillation or carotid stenosis seemed to be less informed about these conditions as risk factors. The knowledge level was low regarding the use of anticoagulants and antiplatelets for stroke/TIA prevention. Better patient educational strategies for stroke/TIA patients should be developed. Furthermore, individuals with less knowledge should be given special consideration when developing strategies and programmes thus improving awareness of stroke risk factors. Birdem Med J 2021; 11(1): 22-29

scholarly journals Sex differences in the risk of recurrent ischemic stroke after ischemic stroke and transient ischemic attack

2021 ◽  
pp. 239698732110585
Author(s):  
Elora Basu ◽  
Setareh Salehi Omran ◽  
Hooman Kamel ◽  
Neal S Parikh
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Ischemic Stroke ◽  
Stroke Risk ◽  
Recurrent Stroke ◽  
Minor Stroke ◽  
Stroke Recurrence ◽  
Stroke Risk Factors ◽  
Minor Ischemic Stroke ◽  
Using Data

Background Sex differences in stroke outcomes have been noted, but whether this extends to stroke recurrence is unclear. We examined sex differences in recurrent stroke using data from the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial. Patients and methods We assessed the risk of recurrent stroke in women compared to men using data from the POINT trial. Adults >18 years old were randomized within 12 hours of onset of minor ischemic stroke or transient ischemic attack (TIA), and followed for up to 90 days for ischemic stroke, our primary outcome. We used Cox proportional hazards model adjusted for demographics and stroke risk factors to evaluate the association between sex and stroke recurrence. We used interaction term testing and prespecified subgroup analyses to determine if the association between sex and recurrent stroke differed by age (<60 versus >60 years old), locale (US versus non-US), and index event type (stroke versus TIA). Last, we evaluated whether sex modified the effect of common stroke risk factors on stroke recurrence. Results Of 4,881 POINT trial participants with minor stroke or high-risk TIA, 2,195 (45%) were women. During the 90-day follow-up period, 267 ischemic strokes occurred; 121 were in women and 146 in men. The cumulative risk of recurrent ischemic stroke was not significantly different among women (5.76%; 95% CI, 4.84%–6.85%) compared to men (5.67%; 95% CI, 4.83%–6.63%). Women were not at a different risk of recurrent ischemic stroke compared to men (hazard ratio [HR], 1.02; 95% CI, 0.80–1.30) in unadjusted models or after adjusting for covariates. However, there was a significant interaction of age with sex (P=0.04). Among patients <60 years old, there was a non-significantly lower risk of recurrent stroke in women compared to men (HR 0.66; 95% CI 0.42–1.05). Last, sex did not modify the association between common stroke risk factors and recurrent stroke risk. Discussion and Conclusion Among patients with minor stroke or TIA, the risk of recurrent ischemic stroke and the impact of common stroke risk factors did not differ between men and women.

Abstract P267: Does Admission for Transient Ischemic Attack Lead to Differences in 1-Year Outcomes?

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Eric Cheng ◽  
Michael Cline ◽  
Joshua Robinson ◽  
Laura Myers ◽  
Flossy Lincoln ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Stroke Risk ◽  
Composite Outcome ◽  
Diagnosis Code ◽  
Stroke Risk Factors ◽  
History Of ◽  
One Year ◽  
Ischemic Attack ◽  
New Diagnosis

Background: A new transient ischemic attack (TIA) is a risk factor for a future vascular event. Reducing that risk requires a timely diagnostic workup and delivering secondary stroke preventive services. It is unknown whether such care should be performed in the inpatient or outpatient setting. Methods: Using administrative databases, we identified all veterans with a diagnosis code for TIA assigned in the emergency department or urgent care setting in the Veterans Health Administration during fiscal year 2008. We calculated the proportion who were admitted and predictors of admission. At one-year after presentation of TIA, we examined the proportion who were assigned a new diagnosis code for stroke, myocardial infarction, or death. We then determined whether admission was associated with outcomes using chi-square and multivariate logistic models. Results: The sample consisted of 2247 persons with a new diagnosis of TIA, and 35% were admitted within one day of presentation. The mean age was 68, and 25% had a prior history of stroke or TIA. At one-year, 12.1% developed the composite outcome of stroke, myocardial infarction, and death. Older age, history of hypertension, atrial fibrillation, and diabetes were associated with admission (p<0.05). In unadjusted analyses, the composite outcome was not significantly different among persons admitted vs. not admitted (13.1% vs. 11.6%, p=0.29). In multivariate analyses, admission was not significantly associated with the composite outcome (see Table ). Discussion: Persons admitted for TIA are more likely to possess stroke risk factors than those who were not admitted. The decision to admit was not associated with differences in one-year outcomes. Ongoing work will compare the completeness and timeliness of the diagnostic work-up of TIA as well as long-term control of stroke risk factors among persons admitted versus persons not admitted. Predictors of 1-year stroke, myocardial infarction, or death among persons with TIA Odds ratio [95% CI] p-value Hospital admission within one day 1.0 [0.8 - 1.4] 0.7 Age 1.0 [1.0 -1.0] <0.001 History of hypertension 1.2 [0.9 - 1.7] 0.2 History of atrial fibrillation 1.5 [1.1 - 2.0] <0.05 History of diabetes 1.2 [0.9 - 1.5] 0.3 History of stroke 1.8 [1.3 - 2.5] <0.001 History of TIA 0.7 [0.5 - 1.1] 0.1 History of myocardial infarction 2.9 [1.3 - 6.1] <0.01

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