Risk Factors, Outcome, and Treatment in Subtypes of Ischemic Stroke: The German Stroke Data Bank

Grau, Armin J.; Weimar, Christian; Buggle, Florian; Heinrich, Annette; Goertler, Michael; Neumaier, S.; Glahn, Joerg; Brandt, Tobias; Hacke, Werner; Diener, Hans‐Christoph

doi:10.1161/hs1101.098524

Cited by 828 publications

(648 citation statements)

References 32 publications

(38 reference statements)

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“…This illustrates a well‐known limitation of the TOAST classification, as the stroke of undetermined cause category not only includes cases of truly unknown cause, but also cases with several potential causes 14, 15. Stroke of undetermined cause comprised the largest subtype among young and middle‐aged patients, which is in accordance with other studies 16, 17, whereas stroke of undetermined cause was outnumbered by cardioembolism among the elderly 18. The lowest proportion of stroke of undetermined cause was found among those younger than 30 years.…”

Section: Discussionsupporting

confidence: 88%

“…Large‐artery atherosclerosis followed a similar time course as small‐vessel occlusions. This corresponds to that of other stroke populations 18, 22. However, while some studies have observed higher proportions of large‐artery atherosclerosis earlier in life 23, 24, our population shows that large‐artery atherosclerosis appears in the 3rd decade, but was not a common finding before the 5th decade and thereafter increased until the 8th decade before decreasing again.…”

Section: Discussionsupporting

confidence: 84%

“…We found hypertension as the most frequent risk factor at all ages. Hypertension plays a particular role in small‐vessel occlusion 25 and is also frequently present in large‐artery atherosclerosis 18, 22. There are some indications that large‐artery atherosclerosis and small‐vessel occlusion are coexisting subtypes of stroke 26, supporting the partly atherosclerotic aetiology of small‐vessel occlusion.…”

Section: Discussionmentioning

confidence: 99%

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Age dependency of ischaemic stroke subtypes and vascular risk factors in western Norway: the Bergen Norwegian Stroke Cooperation Study

et al. 2015

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ObjectivesAge dependency of acute ischaemic stroke aetiology and vascular risk factors have not been adequately evaluated in stroke patients in Norway. Aims of this study were to evaluate how stroke subtypes and vascular risk factors vary with age in a western Norway stroke population.Materials and methodsPatients aged 15–100 years consecutively admitted to our neurovascular centre with acute ischaemic stroke between 2006 and 2012 were included. The study population was categorized as young (15–49 years), middle‐aged (50–74 years) or elderly (≥75 years). Stroke aetiology was defined by TOAST criteria. Risk factors and history of cardiovascular disease were recorded.ResultsIn total, 2484 patients with acute cerebral infarction were included: 1418 were males (57.3%). Mean age was 70.8 years (SD ± 14.9), 228 patients were young, 1126 middle‐aged, and 1130 were elderly. The proportion of large‐artery atherosclerosis and of small‐vessel occlusion was highest among middle‐aged patients. The proportion of cardioembolism was high at all ages, especially among the elderly. The proportion of stroke of other determined cause was highest among young patients. Some risk factors (diabetes mellitus, active smoking, angina pectoris, prior stroke and peripheral artery disease) decreased among the elderly. The proportions of several potential causes increased with age.ConclusionThe proportion of stroke subtypes and vascular risk factors are age dependent. Age 50–74 years constitutes the period in life where cardiovascular risk factors become manifest and stroke subtypes change.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Age dependency of ischaemic stroke subtypes and vascular risk factors in western Norway: the Bergen Norwegian Stroke Cooperation Study

et al. 2015

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“…Our population is similar to those recruited to SPS-3, and our findings support the position that lacunar strokes are a relatively benign stroke subtype 11,12 , with lesser mood disorders in the lacunar group. However, with almost one out of five patients at one year suffering from mood symptoms, lacunar strokes are still associated with a substantial burden of anxiety and depression.…”

Section: Discussionsupporting

confidence: 84%

Lacunar Infarcts, Depression, and Anxiety Symptoms One Year after Stroke

Arba

Ali

Quinn

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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Background: mood disorders are frequent after stroke, and are associated with poorer quality of life. Previous studies have reported conflicting results as to stroke subtype in the incidence of poststroke mood disorders. We explored the relationship between ischemic stroke subtype and presence of such symptoms at one year after stroke. Methods: anonymised data were accessed from the Virtual International Stroke Trials Archive (VISTA). Stroke subtypes were classified according to the Trial of Org 10172 (TOAST) classification. Depression and anxiety symptoms were assessed using Hospital Anxiety and Depression Scale (HADS). We investigated independent predictors of depression and anxiety symptoms using a logistic regression model. Results: data were available for 2160 patients. Almost one fifth of patients developed both anxiety and depression at 1 year follow-up. After adjusting for confounders, the lacunar subtype was least associated with both anxiety (OR=0.65; 95% CI=0.51-0.85) and depression symptoms (OR=0.71; CI=0.55-0.93) versus other stroke subtypes. Conclusions: lacunar strokes have a weaker association with presence of anxiety and depression symptoms compared with other subtypes.

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“…Największe ryzyko ponownego udaru występuje we wczesnej fazie po pierwszym udarze lub TIA [469,470].…”

Section: Wtórna Prewencja Udaru Mózguunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

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Risk Factors, Outcome, and Treatment in Subtypes of Ischemic Stroke: The German Stroke Data Bank

Cited by 828 publications

References 32 publications

Age dependency of ischaemic stroke subtypes and vascular risk factors in western Norway: the Bergen Norwegian Stroke Cooperation Study

Age dependency of ischaemic stroke subtypes and vascular risk factors in western Norway: the Bergen Norwegian Stroke Cooperation Study

Lacunar Infarcts, Depression, and Anxiety Symptoms One Year after Stroke

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

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