VARIATION OF ISCHEMIC STROKE RISK FACTORS IN ASIAN AND WHITE POPULATION IN KYRGYZSTAN : A RETROSPECTIVE COHORT STUDY

Introduction: The relative distribution of stroke risk factors, as well as ischemic stroke subtypes, in women compared with men is not well described. Hypothesis: We hypothesized that the distribution of ischemic stroke risk factors and subtypes would differ by sex, with a later onset in women and greater proportion of comorbidities. Methods: The NINDS Stroke Genetics Network (SiGN) consortium was established to evaluate genetic risk factors for ischemic stroke. A total of 23 separate studies performed Causative Classification of Stroke (CCS) typing using standardized criteria on ischemic stroke cases and contributed data on risk factors. We compared the distribution of ischemic stroke risk factors and CCS phenotypes between men and women with ischemic stroke. Results: Of the 16,228 ischemic strokes in SiGN, 8005 (49.3%) occurred in women. Median age at stroke was older in female than male stroke cases (73 vs. 66 years) (p=<0.0001). Among stroke cases, women were more likely than men cases to have hypertension or atrial fibrillation and less likely to have diabetes or coronary artery disease, or to smoke (p <0.003 for all). The distribution of stroke subtypes also differed by sex, with women less likely than men to have large artery infarction and small artery occlusion, and more likely to have cardioembolic stroke and undetermined stroke due to incomplete work-up (p values all <0.0001; see Table). Results were similar when the distribution of stroke subtypes was examined for those <70 years and ≥70 years, except for cardioembolic stroke remaining more common only among women ≥70. Conclusions: In this large group of carefully phenotyped ischemic strokes, the distribution of ischemic stroke subtypes and risk factor profiles differ significantly by sex. Evaluation of the causes of these differences may highlight areas for improved prevention and risk reduction in both genders.

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Chapter 1. Transient Ischemic Attack, Traumatic Brain Injury, and Ischemic Stroke: Risk Factors and Treatments

Acute Brain Impairment - Drug Discovery ◽

10.1039/9781788012539-00001 ◽

2017 ◽

pp. 1-14

Author(s):

Philip V. Peplow ◽

Jacqueline J. T. Liaw

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Ischemic Stroke ◽

Brain Injury ◽

Transient Ischemic Attack ◽

Stroke Risk ◽

Stroke Risk Factors ◽

Ischemic Stroke Risk ◽

Ischemic Attack

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Incidence of ischemic stroke or transient ischemic attack in patients with multiple risk factors with or without atrial fibrillation: a retrospective cohort study

Current Medical Research and Opinion ◽

10.1185/03007995.2015.1041469 ◽

2015 ◽

Vol 31 (7) ◽

pp. 1257-1266 ◽

Cited By ~ 2

Author(s):

Zhong Yuan ◽

Rupa Makadia ◽

Patrick Ryan ◽

Daniel Yannicelli ◽

Christopher Nessel ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Cohort Study ◽

Ischemic Stroke ◽

Transient Ischemic Attack ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Multiple Risk Factors ◽

Multiple Risk ◽

Ischemic Attack

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Is migraine a risk factor for pediatric stroke?

Cephalalgia ◽

10.1177/0333102415576222 ◽

2015 ◽

Vol 35 (14) ◽

pp. 1252-1260 ◽

Cited By ~ 26

Author(s):

Amy A Gelfand ◽

Heather J Fullerton ◽

Alice Jacobson ◽

Stephen Sidney ◽

Peter J Goadsby ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Ischemic Stroke ◽

Incidence Rate ◽

Stroke Risk ◽

Stroke Incidence ◽

Post Hoc Analysis ◽

Ischemic Stroke Risk ◽

Post Hoc

Importance Our understanding of risk factors for childhood stroke is incomplete. In adults, migraine with aura is associated with a two-fold increase in ischemic stroke risk. Objective In this cohort study we examine the association between migraine and stroke among children in Kaiser Permanente Northern California (KPNC). Design, setting, and participants Children ages 2–17 years who were members of KPNC for ≥6 months between 1997 and 2007 were included. Migraine cohort members had one or more of: an ICD-9 code for migraine, migraine listed as a significant health problem, or a prescription for a migraine-specific medication. The comparison group was children with no evidence of headache. Main outcome measures Main outcome measures included stroke incidence rates and incidence rate ratios (IR). Results Among the 1,566,952 children within KPNC during the study period, 88,164 had migraine, and 1,323,142 had no evidence of headache. Eight migraineurs had a stroke (three (38%) hemorrhagic; five (63%) ischemic). Eighty strokes occurred in children without headache (53 (66%) hemorrhagic; 27 (34%) ischemic). The ischemic stroke incidence rate was 0.9/100,000 person-years in migraineurs vs. 0.4/100,000 person-years in those without headache; IR 2.0 (95% CI 0.8–5.2). A post-hoc analysis of adolescents (12–17 years) showed an increased risk of ischemic stroke among those with migraine; IR 3.4 (95% CI 1.2–9.5). The hemorrhagic stroke incidence rate was 0.5/100,000 person-years in migraineurs and 0.9/100,000 person-years in those without headache; IR 0.6 (95% CI 0.2–2.0). Conclusions There was no statistically significant increase in hemorrhagic or ischemic stroke risk in pediatric migraineurs in this cohort study. A post-hoc analysis found that ischemic stroke risk was significantly elevated in adolescents with migraine. Future studies should focus on identifying risk factors for ischemic stroke among adolescent migraineurs. Based on adult data, we recommend that migraine aura status should be studied as a possible risk factor for ischemic stroke among adolescent migraineurs.

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Arterial Ischemic Stroke in the Pediatric Population

Neurographics ◽

10.3174/ng.1900026 ◽

2019 ◽

Vol 9 (6) ◽

pp. 395-404

Author(s):

R. González‐Odriozola ◽

E. Rawie ◽

H.A. Parmar ◽

F. Rivas‐Rodriguez

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Stroke Risk ◽

Pediatric Population ◽

Arterial Ischemic Stroke ◽

Stroke Risk Factors ◽

Multiple Risk Factors ◽

Ischemic Stroke Risk ◽

High Level ◽

Neuroimaging Techniques

Recognizing childhood arterial ischemic stroke risk factors and presentation are extremely important for a prompt diagnosis and administration of hyperacute treatment requiring a high level of clinical suspicion. Stroke presentation in the pediatric population is not very specific, yet it is imperative to distinguish it from other mimics that may require different medical management. Vascular imaging studies, including MRA, CTA, and advanced neuroimaging techniques (eg, arterial wall imaging and CT/MR perfusion images) are extremely useful in the diagnosis of arterial ischemic stroke. This article offers a review of arterial pediatric ischemic stroke risk factors, clinical presentation, and the imaging appearance of the most common arterial ischemic stroke etiologies.Learning Objective: To recognize multiple risk factors, etiologies, and imaging presentations of pediatric arterial ischemic strokes.

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