The number of risk factors increases the recurrence events in ischemic stroke

Juli, Cep; Heryaman, Henhen; Arnengsih,; Ang, Eng-Tat; Defi, Irma Ruslina; Gamayani, Uni; Atik, Nur

doi:10.1186/s40001-022-00768-y

Cited by 11 publications

(6 citation statements)

References 40 publications

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“…31 This high recurrent stroke incidence rate is associated with multiple risk factors; by managing risk factors, the incidence rate of recurrent stroke is expected to be reduced. 32 The majority of patients had normal sodium, potassium, chloride, and calcium levels, according to the electrolyte study. However, there is a marked difference in decreased potassium levels.…”

Section: Discussionmentioning

confidence: 97%

Ischemic Stroke Risk Factor Profile at Prof. Dr. W. Z. Johannes Hospital, Kupang, East Nusa Tenggara

Pramanasari

2024

AKSONA

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Highlight: Ischemic stroke is a major public health issue in Indonesia. Clinical data correlated to an ischemic stroke patient's prognosis. Several clinical factors and laboratory testing describe the tendency of ischemic stroke patients. ABSTRACT Introduction: In Indonesia, ischemic stroke is a major public health issue. Clinical data correlates with an ischemic stroke patient’s prognosis. Objective: This study aimed to provide an overview of clinical data in ischemic stroke patients from October 2020 to December 2021. Methods: This was a retrospective, descriptive study using medical records. A non-probability purposive sampling strategy with a total sampling method is used in this study. Age, gender, cardiac comorbidities, diabetes, repeated strokes, blood laboratory exams, electrolyte tests, alcohol consumption, and smoking habits were all observed variables. Results: The sample consisted of 242 ischemic stroke patients. The majority of patients (32.23%) were in the 61 to 70 age group, and men (57.4%) made up the majority of the sex group. Then, cardiac comorbidities were dominated by coronary artery disease (CAD), with 33 patients (57.4%) with 4 deaths (12.1%), while 15 patients (6.19%) were found with atrial fibrillation (AF), with 7 deaths (46.67%). Hypertension was found in 81.40% of patients, diabetes in 26.03% of patients, and recurrent stroke in 31.40% of patients. Active smokers make up 52.06% of all patients, and 18.18% are heavy alcohol drinkers. The majority of patients showed blood and electrolyte levels within the normal range, except for an increased leukocyte count and a decreased potassium level. Conclusion: The main risk factors obtained sequentially are hypertension, coronary artery diseases, active smokers, diabetes, and excessive alcohol consumption.

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Section: Discussionmentioning

confidence: 97%

Ischemic Stroke Risk Factor Profile at Prof. Dr. W. Z. Johannes Hospital, Kupang, East Nusa Tenggara

Pramanasari

2024

AKSONA

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“…Risk factors of secondary cardiovascular events are different to those of primary events [ 29 , 30 ]. Here, the study sample consisted of persons with cardiovascular disease, and we also studied stroke recurrence separately.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in modifiable risk factors for stroke incidence and recurrence: the UCC-SMART study

Rissanen,

Basten,

Exalto

et al. 2024

J Neurol

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Background and purpose Risk factors for stroke differ between women and men in general populations. However, little is known about sex differences in secondary prevention. We investigated if sex interacted with modifiable risk factors for stroke in a large arterial disease cohort. Methods Within the prospective UCC-SMART study, 13,898 patients (35% women) with atherosclerotic disease or high-risk factor profile were followed up to 23 years for stroke incidence or recurrence. Hypertension, smoking, diabetes, overweight, dyslipidemia, high alcohol use, and physical inactivity were studied as risk factors. Association between these factors and ischemic and hemorrhagic stroke incidence or recurrence was studied in women and men using Cox proportional hazard models and Poisson regression models. Women-to-men relative hazard ratios (RHR) and rate differences (RD) were estimated for each risk factor. Left-truncated age was used as timescale. Results The age-adjusted stroke incidence rate was lower in women than men (3.9 vs 4.4 per 1000 person-years), as was the age-adjusted stroke recurrence rate (10.0 vs 11.7). Hypertension and smoking were associated with stroke risk in both sexes. HDL cholesterol was associated with lower stroke incidence in women but not in men (RHR 0.49; CI 0.27–0.88; and RD 1.39; CI − 1.31 to 4.10). Overweight was associated with a lower stroke recurrence in women but not in men (RHR 0.42; CI 0.23–0.80; and RD 9.05; CI 2.78–15.32). Conclusions In high-risk population, sex modifies the association of HDL cholesterol on stroke incidence, and the association of overweight on stroke recurrence. Our findings highlight the importance of sex-specific secondary prevention.

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“… 1 Manipulation of unmodifiable and potentially modifiable risk factors contributed to decreased recurrence events in ischemic stroke. 2 Cardioembolic stroke etiology is found following large-artery atherosclerosis and small-vessel occlusion or lacune. 3 A Wernicke’s aphasia or global aphasia without hemiparesis, a Valsalva maneuver at the moment of stroke onset, the co-occurrence of cerebral and systemic emboli, and abrupt onset to the maximal deficit are some clinical characteristics that have been suggestive of cardioembolic stroke, whilst lacunar clinical presentations, and especially multiple lacunar infarcts, make cardioembolic origin unlikely.…”

Section: Introductionmentioning

confidence: 99%

A Simplified Risk Score to Predict In-Hospital Newly-Diagnosed Atrial Fibrillation in Acute Ischemic Stroke Patients

Saengmanee¹,

Thiankhaw²,

Tanprawate³

et al. 2023

IJGM

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Purpose Atrial fibrillation (AF) is a significant cause of stroke, and newly diagnosed AF (NDAF) is typically detected in the early period of stroke onset. We aimed to identify the factors associated with in-hospital NDAF in acute ischemic stroke patients and developed a simplified clinical prediction model. Methods Patients with cryptogenic stroke aged 18 years or older who were admitted between January 2017 and December 2021 were recruited. NDAF was determined by inpatient cardiac telemetry. Univariable and multivariable regression analyses were used to evaluate the factors associated with in-hospital NDAF. The predictive model was developed using regression coefficients. Results The study enrolled 244 eligible participants, of which 52 NDAFs were documented (21.31%), and the median time to detection was two days (1–3.5). After multivariable regression analysis, parameters significantly associated with in-hospital NDAF were elderly (>75 years) (adjusted Odds ratio, 2.99; 95% confident interval, 1.51–5.91; P = 0.002), female sex (2.08; 1.04–4.14; P = 0.04), higher admission national institute of health stroke scale (1.04; 1.00–1.09; P = 0.05), and presence of hyperdense middle cerebral artery sign (2.33; 1.13–4.79; P = 0.02). The area under the receiver operating characteristic curve resulted in 0.74 (95% CI 0.65–0.80), and the cut-point of 2 showed 87% sensitivity and 42% specificity. Conclusion The validated and simplified risk scores for predicting in-hospital NDAF primarily rely on simplified parameters and high sensitivity. It might be used as a screening tool for in-hospital NDAF in stroke patients who initially presumed cryptogenic stroke.

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The number of risk factors increases the recurrence events in ischemic stroke

Cited by 11 publications

References 40 publications

Ischemic Stroke Risk Factor Profile at Prof. Dr. W. Z. Johannes Hospital, Kupang, East Nusa Tenggara

Ischemic Stroke Risk Factor Profile at Prof. Dr. W. Z. Johannes Hospital, Kupang, East Nusa Tenggara

Sex differences in modifiable risk factors for stroke incidence and recurrence: the UCC-SMART study

A Simplified Risk Score to Predict In-Hospital Newly-Diagnosed Atrial Fibrillation in Acute Ischemic Stroke Patients

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