Epidemiology and Outcomes of Ischemic Stroke and Transient Ischemic Attack in the Adult and Geriatric Population

Objectives Ischemic stroke is a common cause of morbidity and mortality especially in the increasingly older population. The variability in ischemic stroke subtypes and its risk factors across different populations suggest that more effort is needed to describe the stroke characteristics in order to develop a more tailored management for each population. We aim to describe the demographic characteristics, risk factors, and subtype distribution of subjects with ischemic stroke in the Lebanese population. Materials and methods We conducted a cross‐sectional study based on chart review on patients with ischemic stroke/transient ischemic attack at the American University of Beirut Medical center between 2015 and 2017. Results: A total of 284 cases were included with a mean age of 72 years, and 58% male gender. The most commonly identified risk factors were hypertension (77%), dyslipidemia (62%), and diabetes mellitus (42%), while atrial fibrillation was only found in 27% of cases. The cohort distribution according to TOAST classification was as follows: 15% large artery stroke, 31% cardioembolic stroke, 17% small artery stroke, 10% stroke of other determined causes, and 27% stroke of unknown cause. Conclusion This is the first study to address ischemic stroke characteristics in Lebanon.

show abstract

“…The prevalence of TIA in our cohort was 4%. This is lower than that of previous studies reporting the TIA prevalence of 9% and 11% …”

Section: Discussioncontrasting

confidence: 80%

“…This is lower than that of previous studies reporting the TIA prevalence of 9% 23 and 11%. 24 The categorization of the stroke subtypes in our cohort differed from any other reported cohort. The proportion of CES subtype was the highest in our cohort (31%) as in Houston (38.7%) and Pakistani (40%) cohorts.…”

Section: Discussioncontrasting

confidence: 55%

TOAST classification and risk factors of ischemic stroke in Lebanon

et al. 2019

View full text Add to dashboard Cite

show abstract

“…ischemic stroke is primarily caused by the blockage of cerebrovascular blood flow. Previous studies have reported that the incidence of early mortality following ischemic stroke (between 21 days to 1 month) in both high-income and low-middle-income countries increased gradually from 2000 to 2008, from 13 to 23% and 13 to 19%, respectively (3,4). currently, intravenous thrombolysis and mechanical thrombectomy are the only effective means of treating ischemic stroke (5,6); however, these treatment options are limited by the short-recommended treatment window (6).…”

Section: Introductionmentioning

confidence: 99%

Modulators of microglia activation and polarization in ischemic stroke (Review)

et al. 2020

View full text Add to dashboard Cite

ischemic stroke is one of the leading causes of mortality and disability worldwide. However, there is a current lack of effective therapies available. as the resident macrophages of the brain, microglia can monitor the microenvironment and initiate immune responses. in response to various brain injuries, such as ischemic stroke, microglia are activated and polarized into the proinflammatory M1 phenotype or the anti-inflammatory M2 phenotype. The immunomodulatory molecules, such as cytokines and chemokines, generated by these microglia are closely associated with secondary brain damage or repair, respectively, following ischemic stroke. it has been shown that M1 microglia promote secondary brain damage, whilst M2 microglia facilitate recovery following stroke. in addition, autophagy is also reportedly involved in the pathology of ischemic stroke through regulating the activation and function of microglia. Therefore, this review aimed to provide a comprehensive overview of microglia activation, their functions and changes, and the modulators of these processes, including transcription factors, membrane receptors, ion channel proteins and genes, in ischemic stroke. The effects of autophagy on microglia polarization in ischemic stroke were also reviewed. Finally, future research areas of ischemic stroke and the implications of the current knowledge for the development of novel therapeutics for ischemic stroke were identified. Contents 1. introduction 2. Microglia 3. Modulatory mechanisms of microglia polarization 4. autophagy 5. conclusions

show abstract

“…Cerebral ischemia results in brain impairment on account of deprivation of oxygen and glucose resulting from blockage of local blood supply. In spite of substantial advances in cerebral ischemic injury therapeutic strategies, the therapeutic effect is still far from ideal for a large number of patients, which is possibly due to a lack of clear understanding of the pathological process [10][11][12]. Thereby, delineating the molecular mechanism of ischemic stroke is urgent to develop effective therapies for cerebral ischemic injury.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of miR-19a protects neurons against ischemic stroke through modulating glucose metabolism and neuronal apoptosis

Wang

Liu

et al. 2019

Cell Mol Biol Lett

View full text Add to dashboard Cite

Background: Accumulating evidence has shown that altered microRNA (miR) modulation is implicated in the pathologies of ischemic stroke. However, it is unclear whether and how hsa-miR-19a-3p mediates cerebral ischemic injury. Herein, we investigated the functional role of miR-19a-3p in cerebral ischemic injury and explored its underlying regulatory mechanism. Methods: In vivo ischemic/reperfusion (I/R) neuronal injury and in vitro oxygenglucose deprivation (OGD) were established. Expression of miR-19a-3p was determined by quantitative real-time polymerase chain reaction (qRT-PCR). Glucose uptake, lactate production, and apoptosis were determined. ADIPOR2 was predicted as a target of miR-19a-3p in silico and experimentally validated by qRT-PCR, Western blot analysis and luciferase assay assays. Results: MiR-19a expression was significantly downregulated and upregulated in rat neurons and astrocytes, respectively (P < 0.01). A significantly elevated level of miR-19a-3p was found in I/R and OGD models in comparison to sham/control groups (P < 0.01). Expression of the glycolysis enzyme markers LDHA, PKM2, HK2, Glut1 and PDK1, apoptosis-related factors levels, apoptosis, glucose uptake, and lactate production were significantly repressed by both I/R and OGD (P < 0.01 in each case). Moreover, miR-19a-3p mimic aggravated, while miR-19a-3p inhibitor alleviated, the above observations. Adipor2 was predicted and confirmed to be a direct target of miR-19a. Furthermore, restoration of Adipor2 reversed miR-19a-3p-induced effects. Conclusions: Collectively, our results indicate that elevated miR-19a-3p mediates cerebral ischemic injury by targeting ADIPOR2. MiR-19a-3p attenuation thus might offer hope of a novel therapeutic target for ischemic stroke injury treatment.

show abstract

Epidemiology and Outcomes of Ischemic Stroke and Transient Ischemic Attack in the Adult and Geriatric Population

Cited by 46 publications

References 21 publications

TOAST classification and risk factors of ischemic stroke in Lebanon

TOAST classification and risk factors of ischemic stroke in Lebanon

Modulators of microglia activation and polarization in ischemic stroke (Review)

Inhibition of miR-19a protects neurons against ischemic stroke through modulating glucose metabolism and neuronal apoptosis

Contact Info

Product

Resources

About