The Comparison of Risk Factors for Ischemic Stroke or Intracranial Hemorrhage in Korean Stroke Patients: A Nationwide Population-based Study

Abstract Background: Although homocysteine (Hcy) and white matter hyperintensities (WMH) have been proven to be correlated with increased risks of ischemic stroke, there have been few studies addressing the association between serum Hcy and WMH in a population with asymptomatic intracranial arterial stenosis (aICAS). Thus, the aim of the present study is to describe the association between Hcy and WMH in rural-dwelling Chinese people with aICAS. Methods: In this study, 150 participants diagnosed as aICAS by magnetic resonance angiography were recruited from the Kongcun Town Study, which was a population-based study aimed to investigate the prevalence of aICAS in general population aged 40 to 90 years old, free of ischemic stroke history, and living in the Kongcun town, Pingyin county, Shandong, China. Data on demographics, risk factors, and serum Hcy levels were collected via interview, clinical examination, and laboratory tests. The WMH volumes were calculated through the lesion segmentation tool system for the Statistical Parametric Mapping package based on magnetic resonance imaging. The association between Hcy and WMH volume was analyzed using both linear and logistic regression analysis. Results: After adjusting for all confounders, high Hcy (HHcy) (serum Hcy ≥15umol/L) was significantly associated with severe WMH (the highest quartile in WMH volume) (OR: 2.972, 95%CI: 1.017-7.979, P <0.05). However, with changing of WMH volumes, only trends towards association with HHcy were observed in all 3 models (P values only slightly exceeded 0.05). After being stratified by age, sex, or ever smoking, the association between HHcy and WMH became more significant in participants who were ≥60 years old, male, or ever smoker. Conclusions: HHcy is associated with severe WMH in rural-dwelling Chinese people with aICAS, especially in participants ≥60 years old, male participants, or ever smokers, indicating these may be risk factors that contribute to the association between HHcy and severe WMH.

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Metabolic Risk Factors of Alzheimer’s Disease, Dementia with Lewy Bodies, and Normal Elderly: A Population-Based Study

Behavioural Neurology ◽

10.1155/2018/8312346 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Chih-Kuang Cheng ◽

Yu-Chien Tsao ◽

Yuan-Chih Su ◽

Fung-Chang Sung ◽

Hsu-Chih Tai ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Ischemic Stroke ◽

Lower Risk ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Population Based ◽

Metabolic Risk Factors ◽

Metabolic Risk ◽

Population Based Study

Background. Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) share many risk factors. Evidence suggests that metabolic risk factors are important to AD; however, their association with DLB is unclear. The risk of cardiovascular diseases (CVD) associated with AD and DLB is also uncertain. Thus, this nationwide, population-based study was designed to evaluate the metabolic and CVD risks in AD and DLB. Materials and Methods. Data were obtained from the Taiwan National Health Insurance Research Database. AD patients, DLB patients, and normal control (NC) individuals from 1996 to 2013 were enrolled for risk assessment. Results. In total, 7544 NC individuals, 1324 AD patients, and 562 DLB patients were enrolled. Participants with one or more metabolic risk factors had significantly higher odds of AD or DLB. No significant differences in metabolic risk factors were observed between DLB and AD patients. AD patients had a lower risk of CVD (aHR = 0.67, 95% CI = 0.59–0.76, p value < 0.001) and coronary artery disease (CAD) (aHR = 0.59, 95% CI = 0.51–0.69, p value < 0.001) than NC. DLB patients had a higher risk of ischemic stroke (aHR = 2.27, 95% CI = 1.68–3.06, p value < 0.001) than NC. Conclusion. Metabolic risk factors are important in AD and DLB. Patients with AD might have a lower risk of CAD and ischemic strokes. Patients with DLB might have a higher risk of ischemic stroke.

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Lipophilic Statins and the Risk of Intracranial Hemorrhage Following Ischemic Stroke: A Population-Based Study

Drug Safety ◽

10.1007/s40264-017-0552-z ◽

2017 ◽

Vol 40 (10) ◽

pp. 887-893 ◽

Cited By ~ 8

Author(s):

Kieran L. Quinn ◽

◽

Erin M. Macdonald ◽

Muhammad M. Mamdani ◽

Christina Diong ◽

...

Keyword(s):

Ischemic Stroke ◽

Intracranial Hemorrhage ◽

Population Based ◽

Population Based Study

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Comparison of metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients: a retrospective study

10.21203/rs.3.rs-551090/v1 ◽

2021 ◽

Author(s):

Xiaolin Huang ◽

Jiaojiao Zhou ◽

Hong Zhang ◽

Pei Gao ◽

Long Wang ◽

...

Keyword(s):

Risk Factors ◽

Recurrent Stroke ◽

Population Based ◽

Metabolic Status ◽

Stroke Patients ◽

Population Based Study ◽

Metabolic Phenotypes ◽

History Of ◽

Integrated Discrimination Improvement ◽

Conventional Risk Factors

Abstract Background Metabolic status and body mass index (BMI) are known as apparent risk factors of recurrent stroke, but which one is more likely related to recurrent stroke remains uncertain. This study aimed to compare the metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients. Methods In this retrospective population-based study, 856 hospitalized stroke patients from the Third Affiliated Hospital of Soochow University were enrolled. Recurrent stroke was defined as newly-onset stroke patients with a history of previous stroke. Metabolic phenotypes were based on Adult Treatment Panel III criteria. BMI ≥ 25kg/m2 was defined as obesity. Results Among the hospitalized stroke patients, the prevalence of recurrent stroke was 21.9%. Metabolic phenotypes rather than BMI were significantly associated with recurrent stroke. Compared with metabolically healthy patients, metabolically unhealthy ones had 72% (odds ratio [OR] = 1.72, 95% confidence interval [CI] 1.01–2.68) increased recurrent stroke, regardless of BMI and other confounding factors. Whereas, no statistical association between BMI and recurrent stroke were found. Metabolic status improved risk prediction of recurrent stroke when adding to conventional risk factors (net reclassification index 17.6%, P = 0.0047; integrated discrimination improvement 0.7%, P = 0.014), while BMI did not. Conclusions Recurrent stroke was likely associated with poor metabolic status rather than with BMI, suggesting that controlling metabolic abnormalities could be an important method for recurrent stroke prevention.

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Cerebral Microbleed Burden in Ischemic Stroke Patients on Aspirin: Prospective Cohort of Intracranial Hemorrhage

Frontiers in Neurology ◽

10.3389/fneur.2021.742899 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chong-xi Xu ◽

Hui Xu ◽

Tong Yi ◽

Xing-yang Yi ◽

Jun-peng Ma

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Intracranial Hemorrhage ◽

Cardiovascular Events ◽

Cerebral Microbleeds ◽

Multivariate Logistic Regression ◽

Stroke Patients

Objective: This investigation aimed at studying the prevalence of cerebral microbleeds (CMBs), including risk factors and the correlation of CMBs to ischemic stroke (IS) patient end results.Methods: Four hundred and fifty-nine acute IS cases were recruited between April 2014 and December 2016. Cerebral microbleeds were analyzed using susceptibility-weighted imaging (SWI) brain MRI scan. The enrolled patients with acute IS were followed up for 12–24 months, with a median follow-up time of 19 months. The follow-up endpoint events including recurrent ischemic stroke (RIS), intracranial hemorrhage (ICH), transient ischemic attack (TIA), mortality, and cardiovascular events. The associations between vascular risk factors and CMBs in IS patients were analyzed using univariate and multivariate logistic regression analysis. Cox regression model was employed for evaluating CMB impact on clinical outcome.Results: Among 459 enrolled patients, 187 (40.7%) had CMBs and 272 (59.2%) had no CMB. In comparison with patients with no CMBs, age was higher and hypertension was more frequent in patients with CMBs. Multivariate logistic regression analyses revealed age and hypertension were independently associated with the presence of CMBs. Among the patient cohort, 450 cases completed the follow-up. During the follow-up period, 22 (4.9%) of patients developed ICH, 12 (2.7%) developed TIA, 68 (15.1%) developed RIS, cardiovascular events occurred in 20 (4.44%), and 13 (2.89%) cases were mortalities. Compared with patients without CMBs, IS patients with CMBs have an increased prevalence of ICH (p < 0.05). However, no statistically valid variations regarding other outcome incidences between both groups was identified (p > 0.05). The incidence of ICH was elevated in tandem with elevations in number of CMBs. Following adjusting for age, multivariate Cox proportional-hazards regression analysis revealed that CMBs ≥10 were independent predictors of ICH in acute IS patients.Conclusion: Age and hypertension are independently associated with the presence of CMBs. Intracranial hemorrhage incidence rate was increased with the number of CMBs, and the number of CMBs ≥10 were independent predictors of ICH in acute stroke patients.

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Effect of previous statin therapy on severity and outcome in ischemic stroke patients: a population-based study

Journal of Neurology ◽

10.1007/s00415-012-6580-9 ◽

2012 ◽

Vol 260 (1) ◽

pp. 30-37 ◽

Cited By ~ 11

Author(s):

Corine Aboa-Eboulé ◽

Christine Binquet ◽

Agnès Jacquin ◽

Marie Hervieu ◽

Claire Bonithon-Kopp ◽

...

Keyword(s):

Ischemic Stroke ◽

Statin Therapy ◽

Population Based ◽

Stroke Patients ◽

Population Based Study

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Abstract T P132: Risk Factors for Spinal Cord Infarct Compared to Those for Stroke and Transverse Myelitis

Stroke ◽

10.1161/str.46.suppl_1.tp132 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Divya Prabhu ◽

Hooman Kamel ◽

Joshua Z Willey

Keyword(s):

Risk Factors ◽

Spinal Cord ◽

Ischemic Stroke ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Transverse Myelitis ◽

Population Based ◽

Vascular Risk ◽

Peripheral Vascular ◽

Stroke Patients

Background: Although spinal cord infarction (SCI) is a rare form of CNS injury, the long-term disability can be substantial. There are limited epidemiological data on the incidence and risk factors of SCI and most prior data were based on small case series of surgical patients. Objectives: To evaluate risk factors for SCI in a contemporary population-based sample, and compare the profiles of those with SCI to those with ischemic stroke and transverse myelitis. Methods: Using California state data on all patients discharged from nonfederal emergency departments or acute care hospitals between 2005 and 2011, we identified all patients with a discharge diagnosis of SCI (ICD9 code = 336.1), ischemic stroke (433.x1, 434.x1, or 436) and transverse myelitis (341.2, 341.3, or 323.82). Age, sex, race, and vascular risk factors were compared among these diagnoses subsets using the Chi square test. Results: The annual incidence of SCI (7 per million) was significantly less than that of stroke (1136 per million). The age of patients with SCI (60.8±18.8) was less than that for patients with stroke (72 ±14.4) but more than that for transverse myelitis (50.6 ±18.5). In general, patients with SCI had vascular risk factors more often than transverse myelitis patients but less often than stroke patients, with the exception of peripheral vascular disease, aortic dissection or rupture, and aortic surgery_all of which were more prevalent among SCI patients than stroke patients. Conclusion: In a large population-based sample of patients, we found that traditional vascular risk were less common with SCI than with ischemic stroke, while peripheral vascular disease and aortic disease or surgeries were more common.

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