Cerebral small vessel disease in Indonesia: Lacunar infarction study from Indonesian Stroke Registry 2012–2014

Abstract

Background and Purpose:Stroke is the number one cause of morbidity and mortality in Indonesia. Lacunar infarction is one of cerebral small vessel disease spectrum. This study aimed to present stroke epidemiology in Indonesia and risk factors associated with cerebral small vessel disease.Methods:A multicenter prospective cross-sectional study of 18 hospitals in Indonesia was conducted using Stroke Case Report Form from 2012 to 2014. Stroke was diagnosed based on clinical findings confirmed with non-contrast computed tomography of the brain. Subjects were classified into two large groups: ischemic (lacunar and non-lacunar) and hemorrhagic (intracranial and subarachnoid hemorrhage). Other risk factors were assessed on admission.Results:We enrolled 5411 patients, of whom 3627 (67.03%) had ischemic stroke and 1784 (32.97%) had hemorrhagic stroke. Male patients were prevalent in both large groups, although found less in subarachnoid hemorrhage group. Among patients with hemorrhagic stroke, 1603 (89.54%) of them had intracerebral hemorrhage and 181 (10.46%) had subarachnoid hemorrhage. From 3627 ischemic stroke patients, 1635 (45.07%) of them had lacunar infarction. We found that age above 55 years old, male gender, hypertension, dyslipidemia, and diabetes were important risk factors associated with lacunar stroke (p < 0.05).Conclusion:Ischemic stroke was the leading cause of stroke in Indonesia. In total, 45% of the total ischemic stroke patients had lacunar infarction. Important risk factors associated with lacunar infarction were hypertension, dyslipidemia, diabetes, age over 55, and male population.

TOAST Subtypes of Ischemic Stroke and Its Risk Factors: A Hospital-Based Study at Cipto Mangunkusumo Hospital, Indonesia

“…Prevalence of small vessel disease, cardioembolism, other determined etiology and undetermined etiology were found in 27,7%; 2,1%; 0,9%; and 9,8% patients, respectively. The result of this study was different with previous multicenter study by Harris et al [ 5 ] in Indonesia which reported that among 3627 patients whom had ischemic stroke, 45,07% of them (n=1635) had lacunar infarction while in our study it was only found in 27,7% of patients (n=65). The difference of the prevalence of small vessel disease was possible considering our hospital is a tertiary and top referral hospital.…”

“…A multicenter prospective cross-sectional study in Indonesia (2018) reported that most common stroke risk factors are hypertension, diabetes mellitus, and dyslipidemia. Among 5411 stroke patients, 67,03% cases were diagnosed with ischemic stroke [ 5 ].…”

Blood Viscosity as a Determining Factor of Ischemic Stroke Outcomes Evaluated With Nihss and MRS on Day 7 and 30 Post-Thrombolysis

“…Most patients (90.9%) had LACI. This result is consistent with Harris et al study on 3627 ischemic stroke patients in Indonesia uncovered that 45.07% of those patients had LACI stroke subtype [39]. Both patients with PACI and patients with LACI had high percentage of blood hyperviscosity, 75.0% and 90.0%, respectively.…”

Selected Benefits of Pentoxifylline in Acute Ischemic Stroke Management: Consideration of Risk Factors

“…The most common stroke type is lacunar stroke (86%). From a study done by Harris et al, lacunar stroke was indeed the most common type of ischemic stroke (Harris et al, 2016). The range of the subject's NIHSS score during admission was 1 to 11 with a median score of 4.…”