scholarly journals Association of Parkinson’s disease with ischemic stroke in Korea: A nationwide longitudinal cohort study in Korea

2021 ◽  
Vol 23 (3) ◽  
pp. 233-239
Author(s):  
Woo Yup Kim ◽  
Hakyung Kim ◽  
Je Beom Hong ◽  
Seung Hun Sheen ◽  
In-bo Han ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Ischemic Stroke ◽  
Confidence Interval ◽  
National Health ◽  
Incidence Rates ◽  
Hazard Ratio ◽  
Stroke Incidence ◽  
Increased Risk ◽  
Age And Sex

Objective: The aim of this nationwide age- and sex- matched longitudinal follow up study is to determine the risk of Parkinson’s disease (PD) associated with ischemic stroke in Korea.Methods: Patient data were collected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). PD was identified using the International Classification of Diseases (ICD) 10-CM code G 20. In total, 6,475 patients were enrolled in the PD group from the NHISS. After subtracting 1,039 patients who underwent hospitalization less than once or those who visited an outpatient clinic less than two times, 5,259 patients who were diagnosed after January 1, 2004 ultimately participated in this study. After case-control match was done through 1:5 age- and sex- stratified matching, 26,295 individuals were chosen as control. Kaplan-Meier method and Cox proportional hazard regression analysis were performed to evaluate the risk of ischemic stroke in PD.Results: The hazard ratio of ischemic stroke in the PD group was 3.848 (95% confidence interval (confidence interval [CI]): 3.14-4.70) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in PD group was 3.885 (95% CI: 3.17-4.75) after adjusting for comorbidities. According to subgroup analysis, in male and female and non-diabetes and diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in the PD group than those in the control group.Conclusions: This nationwide longitudinal study suggests an increased risk of ischemic stroke in PD patients.

scholarly journals Incidence of Ischemic Stroke in Individuals With and Without Aortic Valve Stenosis

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1364-1371
Author(s):  
Charlotte Andreasen ◽  
Gunnar H. Gislason ◽  
Lars Køber ◽  
Jawdat Abdulla ◽  
Andreas Martinsson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Incidence Rates ◽  
Hazard Ratio ◽  
Relative Risks ◽  
Increased Risk ◽  
Age And Sex

Background and Purpose— Aortic valve stenosis may lead to atrial and ventricular remodeling, predisposes to atrial fibrillation, and may also be an independent risk factor of ischemic stroke. However, information on stroke rates among persons with aortic valve stenosis are sparse. We aimed to determine the incidence rates and relative risks of ischemic stroke in individuals with diagnosed aortic valve stenosis compared with age- and sex-matched controls. Methods— All patients with incident aortic valve stenosis aged >18 years (n=79 310) and age- and sex-matched controls were identified using the Danish nationwide registries (1997–2017). Incidence rates per 1000 person-years (PY) and multivariable adjusted hazard ratios with 95% CIs were reported. Results— In total, 873 373 individuals (median age 77 years, 51.5% men, 9.1% with aortic valve stenosis) were included. Ischemic stroke occurred in 70 205 (8.0%) individuals during 4 880 862 PY of follow-up. Incidence rates of ischemic stroke were 13.3/1000 PY among the controls compared with 30.4/1000 PY in patients with aortic valve stenosis, corresponding to a hazard ratio of 1.31 (95% CI, 1.28–1.34). In all age-groups, the incidence rates and relative risks were significantly increased in patients with aortic valve stenosis compared with controls, but the relative risk was greater for younger individuals (eg, age group, 18–45 years: hazard ratio, 5.94 [95% CI, 4.10–8.36]). In patients with aortic valve stenosis above 65 years of age, the risk of ischemic stroke was markedly lower after aortic valve replacement (30.3 versus 19.6/1000 PY before and after valve replacement). Among people with atrial fibrillation the incidence rate of ischemic stroke was 1.5 times higher when aortic valve stenosis was present (33.0/1000 PY versus 49.9/1000 PY). Conclusions— People with aortic valve stenosis have a significantly increased risk of ischemic stroke compared with age- and sex-matched controls. Future studies are warranted to explore whether antithrombotic therapy may be beneficial in some individuals.

scholarly journals Assessment of Atrial Conduction Times in Patients with Newly Diagnosed Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Yiğit Çanga ◽  
Ayşe Emre ◽  
Gülbün Asuman Yüksel ◽  
Mehmet Baran Karataş ◽  
Nizamettin Selçuk Yelgeç ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Ischemic Stroke ◽  
Electromechanical Coupling ◽  
P Wave ◽  
Volume Index ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Atrial Conduction Times

Background. An increased risk of ischemic stroke has been reported in patients with Parkinson’s disease (PD). Atrial fibrillation (AF) is strongly associated with ischemic stroke. Prolonged atrial electromechanical delay (EMD) is an independent predictor for the development of AF. Aims. The aim of the present study was to evaluate the atrial conduction parameters in patients with PD and to assess their relation with the severity of PD. Study design. We prospectively enrolled 51 consecutive patients with newly diagnosed PD and 31 age- and sex-matched non-PD subjects. Methods. To assess atrial electromechanical coupling (PA), the time intervals from the onset of p wave on ECG to the late diastolic wave at the septal (PAs) and lateral (PAl) mitral annulus and lateral tricuspid annulus (PAt) were measured on Tissue Doppler Echocardiography (TDE). The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial EMD, respectively. P-wave dispersion (PWD) was calculated from the 12-lead ECG. Results. PWD, PAs, PAl, and PAt durations were significantly prolonged in the PD group (all p<0.001). Interatrial, right, and left intra-atrial EMD were also significantly longer in PD patients (p<0.001, p<0.001 and p=0.002, resp.). There were significant positive correlations between disease severity (UPDRS score) and PWD (r=0.34, p=0.041), left intra-atrial (r=0.39, p=0.005), and interatrial EMD (r=0.35, p=0.012). By multivariate analysis, PWD (OR: 1.13, 95% CI: 1.02–1.25; p=0.017), LA volume index (OR: 1.19, 95% CI: 1.02–1.37; p=0.021), left intra-atrial (OR: 1.12, 95% CI: 1.01–1.24; p=0.041), and interatrial EMD (OR: 1.08, 95% CI: 1.01–1.16; p=0.026) were found as independent predictors of PD. Conclusion. Atrial conduction times were longer and correlated with the severity of disease in PD patients. Prolonged inter- and intra-atrial-EMD intervals were also found as independent correlates of PD. These findings may suggest an increased predisposition to atrial fibrillation in PD.

scholarly journals Electrocardiographic ST-T Abnormities Are Associated With Stroke Risk in the REGARDS Study

Stroke ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 1100-1106
Author(s):  
Mitsuaki Sawano ◽  
Ya Yuan ◽  
Shun Kohsaka ◽  
Taku Inohara ◽  
Takeki Suzuki ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Racial Differences ◽  
Stroke Risk ◽  
Proportional Hazards ◽  
The United States ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Common Finding ◽  
Increased Risk

Background and Purpose— In previous studies, isolated nonspecific ST-segment and T-wave abnormalities (NSSTTAs), a common finding on ECGs, were associated with greater risk for incident coronary artery disease. Their association with incident stroke remains unclear. Methods— The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study is a population-based, longitudinal study of 30 239 white and black adults enrolled from 2003 to 2007 in the United States. NSSTTAs were defined from baseline ECG using the standards of Minnesota ECG Classification (Minnesota codes 4-3, 4-4, 5-3, or 5-4). Participants with prior stroke, coronary heart disease, and major and minor ECG abnormalities other than NSSTTAs were excluded from analysis. Multivariable Cox proportional hazards regression was used to examine calculate hazard ratios of incident ischemic stroke by presence of baseline NSSTTAs. Results— Among 14 077 participants, 3111 (22.1%) had NSSTTAs at baseline. With a median of 9.6 years follow-up, 106 (3.4%) with NSSTTAs had ischemic stroke compared with 258 (2.4%) without NSSTTAs. The age-adjusted incidence rates (per 1000 person-years) of stroke were 2.93 in those with NSSTTAs and 2.19 in those without them. Adjusting for baseline age, sex, race, geographic location, and education level, isolated NSSTTAs were associated with a 32% higher risk of ischemic stroke (hazard ratio, 1.32 [95% CI, 1.05–1.67]). With additional adjustment for stroke risk factors, the risk of stroke was increased 27% (hazard ratio, 1.27 [95% CI, 1.00–1.62]) and did not differ by age, race, or sex. Conclusions— Presence of NSSTTAs in persons with an otherwise normal ECG was associated with a 27% increased risk of future ischemic stroke.

scholarly journals Seasonal Variation in Incidence of Stroke in a General Population of 1.4 Million Japanese: The Shiga Stroke Registry

2021 ◽  
pp. 1-7
Author(s):  
Takako Fujii ◽  
Hisatomi Arima ◽  
Naoyuki Takashima ◽  
Yoshikuni Kita ◽  
Naomi Miyamatsu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Seasonal Variation ◽  
General Population ◽  
Intracerebral Hemorrhage ◽  
Large Scale ◽  
Population Based ◽  
Incidence Rates ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Age And Sex

<b><i>Introduction:</i></b> The purpose of this study was to investigate seasonal variation in stroke incidence using data from a large-scale stroke registry of general population in current Japan. <b><i>Methods:</i></b> Shiga Stroke Registry (SSR) is an ongoing population-based registry of stroke that occurred in the Shiga Prefecture in central Honshu, Japan. A total 6,688 cases of first-ever stroke, with onset dates ranging from 1 January 2011 to 31 December in 2013 were included in this study. Incidence rates of first-ever stroke in each season were estimated using the person-year approach and adjusted for age and sex using the Poisson regression models. <b><i>Results:</i></b> From 2011 to 2013, we identified a total of 6,688 stroke cases (3,570 men, 3,118 women), of which 4,480 cases had ischemic stroke (2,518 men, 1,962 women), 1,588 had intracerebral hemorrhage (857 men, 731 women) and 563 had subarachnoid hemorrhage (166 men, 397 women). Age- and sex-adjusted incidence rates of total stroke were 151 (95% confidence interval [CI] 144–160, <i>p</i> = &#x3c;0.001 vs. summer) in spring, 130 (95% CI 122–137) in summer, 141 (95% CI 133–149, <i>p</i> = 0.020 vs. summer) in autumn and 170 (95% CI 161–179, <i>p</i> = &#x3c;0.001 vs. summer) in winter. Seasonal variation was more pronounced in intracerebral hemorrhage than in ischemic stroke. <b><i>Conclusion:</i></b> In the present large-scale stroke registry of general population, incidence rates of stroke were highest in winter and lowest in summer in current Japan.

scholarly journals The Occurrence of Alzheimer’s Disease and Parkinson’s Disease in Individuals With Osteoporosis: A Longitudinal Follow-Up Study Using a National Health Screening Database in Korea

2021 ◽  
Vol 13 ◽  
Author(s):  
Mi Jung Kwon ◽  
Joo-Hee Kim ◽  
Ji Hee Kim ◽  
Seong Jin Cho ◽  
Eun Sook Nam ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
National Health ◽  
Health Screening ◽  
Incidence Rates ◽  
Residential Area ◽  
Follow Up Study

Background: Public health concerns regarding the potential link between osteoporosis and the increased occurrence of Alzheimer’s disease (AD) and Parkinson’s disease (PD) have been raised, but the results remain inconsistent and require further validation. Here, we investigated the long-term relationship of osteoporosis with the occurrence of AD/PD using data from a large-scale nationwide cohort.Methods: This longitudinal follow-up study included 78,994 patients with osteoporosis and 78,994 controls from the Korean National Health Insurance Service-Health Screening Cohort database (2002–2015) who were matched using propensity score matching at a 1:1 ratio based on age, sex, income, and residential area. A Cox proportional hazard model was used to assess the association between osteoporosis and the occurrence of AD/PD after adjusting for multiple covariates.Results: During the follow-up period, AD occurred in 5,856 patients with osteoporosis and 3,761 controls (incidence rates: 10.4 and 6.8 per 1,000 person-years, respectively), and PD occurred in 1,397 patients and 790 controls (incidence rates: 2.4 and 1.4 per 1,000 person-years, respectively). The incidences of AD and PD were significantly higher in the osteoporosis group than in the matched control group. After adjustment, the osteoporosis group exhibited 1.27-fold and 1.49-fold higher occurrences of AD (95% confidence interval (CI) = 1.22–1.32) and PD (95% CI = 1.36–1.63) than the controls, respectively. The results of subgroup analyses supported the increased occurrence of AD and PD in patients with osteoporosis, independent of income, residential area, obesity, smoking, alcohol consumption, hyperlipidemia, hypertension, or blood glucose level.Conclusion: Our results indicate that the presence of osteoporosis may increase the likelihood of developing two common neurodegenerative diseases in adults aged ≥40 years.

Abstract 057: Increased Incidence of Ischemic Stroke in HIV-Infected Women in a Clinical Care Cohort

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Felicia C Chow ◽  
Susan Regan ◽  
Steven Feske ◽  
James B Meigs ◽  
Steven K Grinspoon ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Stroke ◽  
Hiv Infection ◽  
Clinical Care ◽  
Age Groups ◽  
Incidence Rates ◽  
Hazard Ratio ◽  
Right Censoring ◽  
Stroke Event ◽  
Stroke Incidence

Introduction: Coronary heart disease rates are increased among HIV-infected patients compared to control groups, with a relatively greater increase in women compared to men. Whether a similar pattern with respect to gender is true for ischemic stroke is not known. We assessed the hypothesis that the adjusted hazard ratio for ischemic stroke given HIV infection is greater among women compared to men. Methods: The study was conducted using data from an HIV observational clinical care cohort at a large Boston-based health care system. A control cohort of non-HIV-infected patients was matched in a 10:1 ratio to the HIV cohort based on age, gender, and race. The observation period was between 1996 and 2009, with right censoring at the initial stroke event or last encounter if prior to 2009. Ischemic stroke events were identified by pre-specified and validated ICD-9-CM codes. Gender-specific stroke incidence rates were calculated. To assess the association of HIV and ischemic stroke within each gender, Cox proportional hazard modeling was employed. Results: The cohorts consisted of 4,308 HIV-infected patients (31% women) and 32,423 non-HIV-infected patients (35% women). Among women, ischemic stroke event rates were 5.02 per 1000 person years (PY) in HIV-infected versus 2.31 per 1000 PY in non-HIV-infected patients (40 events in HIV and 177 events in non-HIV) with an unadjusted hazard ratio (HR) of 2.16 (95% confidence interval [CI] 1.53–3.04, P <0.001). In contrast, among men ischemic stroke rates were 5.38 per 1000 PY in HIV-infected versus 4.59 per 1000 PY in non-HIV-infected patients (92 events in HIV and 605 events in non-HIV patients) with an unadjusted HR of 1.18 (95% CI 0.95–1.47, P =0.14). Comparing HIV-infected to non-HIV-infected patients, incidence rates were significantly increased among women in the 18–29, 30–39, and 40–49 age groups and among men in the 30–39 age group. In a gender-stratified, multivariate regression model adjusting for age, race, hypertension, diabetes, dyslipidemia, smoking, structural heart disease, atrial fibrillation, aspirin use, and warfarin use, the adjusted HR for stroke associated with HIV infection was 1.76 (95% CI 1.24–2.52, P =0.002) among women compared with 1.05 (95% CI 0.84–1.32, P =0.639) among men. Conclusions: Ischemic stroke incidence rates were significantly increased in HIV-infected patients compared to non-HIV-infected patients among young women (< 50) and a subset of young men. HIV infection remained independently associated with stroke among women after adjusting for demographic and traditional stroke risk factors. While further studies are merited investigating causality and potential mechanisms for stroke among HIV-infected women, this group may represent a uniquely at-risk population for accelerated cerebrovascular aging.

scholarly journals Environmental Risk Factors for Parkinson's Disease: The Epidemiologic Evidence

1987 ◽  
Vol 14 (S3) ◽  
pp. 407-413 ◽  
Author(s):  
Bruce S. Schoenberg
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Temporal Trends ◽  
Incidence Rates ◽  
Etiologic Factor ◽  
Inverse Association ◽  
Epidemiologic Evidence ◽  
Increased Risk ◽  
Prevalence Ratios ◽  
The U.S

ABSTRACT:Descriptive data from several studies suggest variations in the frequency of Parkinson's disease in different population groups. Door-to-door surveys were carried out among a biracial U.S. population (blacks and whites) and in communities in Nigeria and the People's Republic of China. The U.S. investigation revealed no substantial differences in the age-adjusted prevalence ratios by race. However, blacks in Nigeria have a much lower prevalence ratio than blacks in the U. S., suggesting an environmental etiologic factor. Prevalence ratios derived from China are also lower than the U.S. figures. Studies of temporal trends in the incidence rates in one U.S. population (Rochester, Minnesota) show virtually no change over 35 years, indicating that the primary cause(s) of Parkinson's disease must have been present in this nonindustrialized community for many years. Analytic studies generally reveal an inverse association between Parkinson's disease and cigarette smoking, although epidemiologic evidence does not support a direct protective effect of smoking. Preliminary investigations suggest an increased risk associated with the rural environment and the consumption of well water. Further studies are required to discover as yet unknown environmental factors that heighten the risk of Parkinson's disease.

scholarly journals Parkinson’s Disease Is Related to an Increased Risk of Ischemic Stroke—A Population-Based Propensity Score-Matched Follow-Up Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (9) ◽  
pp. e68314 ◽  
Author(s):  
Ya-Ping Huang ◽  
Li-Sheng Chen ◽  
Ming-Fang Yen ◽  
Ching-Yuan Fann ◽  
Yueh-Hsia Chiu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Ischemic Stroke ◽  
Propensity Score ◽  
Population Based ◽  
Follow Up Study ◽  
Increased Risk

Blood pressure levels and the risk of intracerebral hemorrhage after ischemic stroke

Neurology ◽  
2016 ◽  
Vol 88 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Nina A. Hilkens ◽  
Jacoba P. Greving ◽  
Ale Algra ◽  
Catharina J.M. Klijn
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Confidence Interval ◽  
Intracerebral Hemorrhage ◽  
Incidence Rate ◽  
Hazard Ratio ◽  
Stroke Subtype ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Ischemic Stroke Subtype

Objective:To investigate the association between blood pressure (BP) levels and risk of intracerebral hemorrhage (ICH) after ischemic stroke.Methods:We performed a post hoc analysis of data from the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial, a randomized clinical trial including 20,332 patients with recent noncardioembolic ischemic stroke. BP measurements were divided into predefined categories. We calculated incidence rates per BP category and performed multivariable Cox regression analysis with systolic blood pressure (SBP) and diastolic blood pressure (DBP) categories as time-dependent covariables.Results:One hundred thirty-three ICHs occurred during 50,778 person-years of follow-up, resulting in an incidence rate of 2.6 per 1,000 person-years. The incidence rate of ICH increased with increasing SBP and DBP categories. Risk of ICH was significantly higher in patients with SBP ≥160 mm Hg (hazard ratio 2.27, 95% confidence interval 1.34–3.86) compared with those with SBP of 130–<140 mm Hg and in patients with DBP ≥100 mm Hg (hazard ratio 3.08, 95% confidence interval 1.78–5.34) compared with those with DBP of 80–<90 mm Hg. The association between SBP or DBP and ICH did not differ by ischemic stroke subtype (p = 0.55 and 0.93).Conclusions:Among patients with recent noncardioembolic ischemic stroke, the risk of ICH is high. High SBP and DBP are associated with an increased risk of ICH. The association between BP and ICH is not dependent on ischemic stroke subtype.

scholarly journals Association between ischemic stroke and seropositive rheumatoid arthritis in Korea: A nationwide longitudinal cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251851
Author(s):  
Dong Hyun Lee ◽  
Seung Hun Sheen ◽  
Dong-Geun Lee ◽  
Jae-Won Jang ◽  
Dong Chan Lee ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ischemic Stroke ◽  
Hazard Ratio ◽  
Control Group ◽  
Medical Disorders ◽  
Seropositive Rheumatoid Arthritis ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Age And Sex

The purpose of this longitudinal follow-up study was to investigate the risk of ischemic stroke nationwide in patients with seropositive rheumatoid arthritis (RA) and controls who were matched in age and sex. Patient data were collected from the National Health Insurance Service (NHIS) Health Screening (HEALS) cohort. Using the International Classification of Diseases code M05 (seropositive RA), with a prescription of any disease-modifying anti-rheumatic drug (DMARD), RA was identified. A total of 2,765 patients and 13,825 control subjects were included in our study. The 12-year incidence of ischemic stroke in each group was calculated using the Kaplan–Meier method. The risk ratio of ischemic stroke was estimated using Cox proportional hazards regression. Sixty-four patients (2.31%) in the seropositive RA group and 512 (3.70%) in the control group experienced ischemic stroke (P < 0.001) during the follow-up period. The hazard ratio of ischemic stroke in the seropositive RA group was 1.32 (95% confidence interval (CI), 1.02–1.73) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in the seropositive RA group was 1.40 (95% CI, 1.07–1.82) after adjusting for demographics and comorbid medical disorders. According to the subgroup analysis, the hazard ratios of ischemic stroke risks in the female and hypertensive subgroups were 1.44 (95% CI, 1.05–1.97) and 1.66 (95% CI, 1.16–2.38), respectively. In the non-diabetes and non-dyslipidemia subgroups, the corresponding hazard ratios of ischemic stroke were 1.47 (95% CI, 1.11–1.95) and 1.43 (95% CI, 1.07–1.91). Seropositive RA patients have an increased risk of ischemic stroke. In female, hypertension, non-diabetes, and non-dyslipidemia RA subgroups, even without the traditional risk factors for stroke (except for hypertension), increased the risk, which could be potentially attributed to RA.

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