Incidence, early case fatality and determinants of stroke in Iran: Golestan Cohort Study

Motamed-Gorji, Nazgol; Hariri, Sanam; Masoudi, Sahar; Sharafkhah, Maryam; Nalini, Mahdi; Oveisgharan, Shahram; Khoshnia, Masoud; Motamed-Gorji, Nogol; Gharavi, Abdolsamad; Etemadi, Arash; Zand, Ramin

doi:10.1016/j.jstrokecerebrovasdis.2022.106658

Cited by 2 publications

(3 citation statements)

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“…We have previously reported that prestroke PA was associated with lower NIHSS scores on admission and decreased short-term and long-term morality hazards for patients with ischaemic stroke and ICH 9. In another recent study, prestroke PA was the only significant predictor of case fatality in 203 patients with haemorrhagic stroke (including ICH and subarachnoid haemorrhages) 23. Studies on ischaemic strokes have found associations between regular PA and improved short-term and long-term clinical outcome, increased levels of endothelial growth factor and insulin-like growth factor I as well as smaller infarct volumes 24.…”

Section: Discussionmentioning

confidence: 92%

“… 9 In another recent study, prestroke PA was the only significant predictor of case fatality in 203 patients with haemorrhagic stroke (including ICH and subarachnoid haemorrhages). 23 Studies on ischaemic strokes have found associations between regular PA and improved short-term and long-term clinical outcome, increased levels of endothelial growth factor and insulin-like growth factor I as well as smaller infarct volumes. 24 Although related mechanism for ICH remain unknown, PA may to promote cerebral ischaemic tolerance via beneficial effects on the autonomic regulation, with improved cardiac function, and increased cerebral blood flow.…”

Section: Discussionmentioning

confidence: 99%

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Prestroke physical activity is associated with admission haematoma volume and the clinical outcome of intracerebral haemorrhage

et al. 2023

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BackgroundPrestroke physical activity (PA) has been linked to improved outcomes after intracerebral haemorrhage (ICH), but its association with ICH volume is unknown. We aimed to investigate associations of prestroke PA with location-specific haematoma volume and the clinical outcome of ICH.MethodsAll patients with primary ICH, admitted to three hospitals between 2014 and 2019, were included. Patients performing light PA ≥4 hour/week the year before stroke were considered physically active. Haematoma volumes were assessed from admission brain imaging. Adjusted associations were estimated using multivariate linear and logistic regression models. Haematoma volume was explored as mediator to the relationship between prestroke PA and mild stroke severity (0–4 points on the National Institutes of Health Stroke Scale), a good 1-week functional status (0–3 points on the modified Rankin Scale) and 90-day survival. Average direct effects (ADE) and average causal mediation effects (ACME) were computed.ResultsOf 686 primary ICH cases, 349 were deep, 240 lobar and 97 infratentorial. Prestroke PA predicted smaller haematoma volumes in deep ICH (β=−0.36, SE=0.09, p<0.001) and lobar ICH (β=−0.23, SE=0.09, p=0.016). Prestroke PA was also associated with mild stroke severity (OR 2.53, 95% CI 1.59 to 4.01), a good 1-week functional status (OR 2.12, 95% CI 1.37 to 3.30) and 90-day survival (OR 3.48, 95% CI 2.06 to 5.91). Haematoma volume partly mediated the relationships between PA and stroke severity (ADE 0.08, p=0.004; ACME 0.10, p<0.001), 1-week functional status (ADE 0.07, p=0.03; ACME 0.10, p<0.001) and 90-day survival (ADE 0.14, p<0.001; ACME 0.05, p<0.001).ConclusionsLight PA ≥4 hour/week prior to ICH was associated with smaller haematoma volumes in deep and lobar locations. Physically active patients with ICH had a higher likelihood of mild stroke, a good 1-week functional status and 90-day survival, in part mediated by smaller haematoma volumes on admission.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Prestroke physical activity is associated with admission haematoma volume and the clinical outcome of intracerebral haemorrhage

et al. 2023

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“…The 16 cohorts selected for the meta-analysis included overall 752 052 followed-up subjects, with a mean follow-up length of 125.7±77.5 months. 14 cohort studies reported cumulative RR data of any stroke [16][17][18][19][20][21][22][23][24][25][26][27][28][29] either ischaemic or haemorrhagic; 3 cohort studies reported the RR for ischaemic 17 25 30 and 2 the RR for haemorrhagic stroke. 17 25 The main characteristics of the cohort studies reporting stroke incidence are summarised in table 2 (details on the comparison of different levels of LTPA in each subgroup of cohort studies are accessible in the online supplemental tables 1-5).…”

Section: Literature Searchmentioning

confidence: 99%

Risk of stroke with different levels of leisure-time physical activity: a systematic review and meta-analysis of prospective cohort studies

De Santis,

Romoli,

Foschi

et al. 2024

J Neurol Neurosurg Psychiatry

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BackgroundLeisure-time physical activity (LTPA) protects against vascular diseases. Whether and to what extent different levels of LTPA, including lower ones, benefit stroke prevention is still unclear.MethodsWe searched prospective cohort studies, indexed on PubMed and Scopus, published in English up to 22 April 2023, that investigated, in a general healthy population, the relationship between different predefined LTPA levels, compared with inactivity, and the risk of any type of stroke. We applied random effect modelling for meta-analyses and meta-regression to control for the impact of age and sex.ResultsOut of 3064 screened articles, 15 articles on 16 cohorts of subjects were included in meta-analyses, with a total of 752 050 followed-up subjects. Mean follow-up was 125.7±77.5 months. Included studies identified three (none, below target and ideal) to five (none, insufficient, low, moderate and intense) levels of LTPA. In the five studies identifying three levels of LTPA, compared with no LTPA, below target (risk ratio (RR)=0.82, 95% CI=0.75 to 0.88) and ideal LTPA significantly reduced stroke risk (RR=0.71, 95% CI=0.58 to 0.86).Lower levels of LTPA also mitigated stroke risk in studies reporting on four (n=6; RR=0.73, 95% CI=0.62 to 0.87 favouring moderate LTPA over no LTPA) and five levels (n=2; RR=0.71, 95% CI=0.58 to 0.88 favouring moderate LTPA over no LTPA). The benefits of LTPA were independent of age and sex.ConclusionsAccording to our results, all levels of LTPA can be beneficial for stroke prevention, including levels currently regarded as low or insufficient. People should be encouraged to be physically active even at the lowest levels.PROSPERO registration numberCRD42023425302.

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Incidence, early case fatality and determinants of stroke in Iran: Golestan Cohort Study

Cited by 2 publications

References 70 publications

Prestroke physical activity is associated with admission haematoma volume and the clinical outcome of intracerebral haemorrhage

Prestroke physical activity is associated with admission haematoma volume and the clinical outcome of intracerebral haemorrhage

Risk of stroke with different levels of leisure-time physical activity: a systematic review and meta-analysis of prospective cohort studies

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