Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke

doi:10.12998/wjcc.v3.i5.418

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World Journal of Clinical Cases

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World J Clin Cases. May 16, 2015; 3(5): 418-429
Published online May 16, 2015. doi: 10.12998/wjcc.v3.i5.418

Table 1 Distribution by age groups of demographic and cardiovascular risk factors in 2704 consecutive patients with cerebral infarction collected from the “Sagrat Cor Hospital of Barcelona Stroke Registry”[7] n (%)

Data	< 65 yr (n = 386)	65-74 yr (n = 680)	≥75-84 yr (n = 1068)	≥85 yr (n = 570)
Gender
Males	270 (69.9)	409 (60.1)	471 (44.1)	186 (32.6)
Females	116 (30.1)	271 (39.9)	597 (55.9)	384 (67.4)
Vascular risk factors
Hypertension	186 (48.2)	415 (61)	624 (58.4)	276 (48.4)
Atrial fibrillation	38 (9.8)	157 (23.1)	366 (34.3)	246 (43.2)
Diabetes mellitus	90 (23.3)	187 (27.5)	252 (23.6)	103 (18.1)
Dyslipidemia	86 (22.3)	179 (26.3)	161 (15.1)	54 (9.5)
Previous cerebral infarction	42 (10.9)	130 (19.1)	194 (18.2)	102 (17.9)
Ischemic heart disease	37 (9.6)	128 (18.8)	185 (17.3)	85 (14.9)
Smoking (> 20 cigarettes/d)	34 (8.8)	85 (12.5)	132 (12.4)	66 (11.6)
COPD	112 (29)	88 (12.9)	50 (4.7)	10 (1.8)
Peripheral vascular disease	14 (3.6)	54 (7.9)	103 (9.6)	52 (9.1)
Heart valve disease	22 (5.7)	79 (11.6)	86 (8.1)	27 (4.7)
Congestive heart failure	26 (6.7)	46 (6.8)	69 (6.5)	33 (5.8)
Obesity (BMI ≥ 30 kg/m²)	7 (1.8)	16 (2.4)	54 (5.1)	71 (12.5)
Oral anticoagulants	20 (5.2)	42 (6.2)	44 (4.1)	12 (2.1)
Alcohol abuse (≥ 80 g/d)	10 (2.6)	25 (3.7)	41 (3.8)	18 (3.2)
Previous cerebral hemorrhage	38 (9.8)	20 (2.9)	7 (0.7)	1 (0.2)

Data expressed as frequencies and percentages in parenthesis. COPD: Chronic obstructive pulmonary disease; BMI: Body mass index.

Table 2 Comparison of demographic data, risk factors, neuroimaging findings and early outcome between stroke patients with intracerebral hemorrhage and cerebral infarctions (“Sagrat Cor Hospital of Barcelona Stroke Registry” period 1986-2004)[72] n (%)

Variable	Intracerebral hemorrhage (n = 380)	Cerebral infarction (n = 2082)
Age, yr, mean (SD)	72.51 (12.55)	74.97 (12.21)
Age, yr
< 65	83 (21.8)	329 (15.8)
65-74	112 (29.5)	521 (25.0)
75-84	120 (31.6)	808 (38.8)
≥ 85	65 (17.1)	424 (20.4)
Gender
Males	199 (52.4)	987 (47.4)
Females	171 (47.6)	1095 (52.6)
Lacunar syndromes	36 (9.5)	554 (31.4)
Hypertension	233 (61.3)	1126 (54.1)
Diabetes mellitus	56 (14.7)	471 (22.6)
Atrial fibrillation	58 (15.3)	609 (29.3)
COPD	29 (7.6)	166 (8.0)
Magnetic resonance imaging	95 (25)	656 (31.5)
Respiratory events	45 (11.8)	183 (8.8)
Symptom-free at discharge	23 (6.1)	382 (18.3)
In-hospital mortality	107 (28.2)	249 (12.0)
Transfer to a convalescence/rehabilitation unit	64 (16.8)	243 (11.7)
Length of stay, median (IQR)	15 (8-26)	12 (8-20)

Data expressed as frequencies and percentages in parentheses unless otherwise stated. COPD: Chronic obstructive pulmonary disease; IQR: Interquartile range (25^th-75^th percentile).

Table 3 Cardiovascular risk factors in 2704 consecutive patients with cerebral infarction collected from the “Sagrat Cor Hospital of Barcelona Stroke Registry” according to the different stroke subtypes[7] n (%)

Variables	Atherothrombotic(n = 770)	Lacunar(n = 773)	Cardioembolic(n = 763)	Undeterminedcause (n = 324)	Unusual cause(n = 114)
Hypertension	509 (66.1)^b	525 (71.6)^b	377 (49.4)^b	59 (18.2)^b	31 (27.2)^b
Atrial fibrillation	120 (15.6)^b	81 (11.1)^b	573 (75.1)^b	25 (7.7)^b	8 (7)^b
Diabetes mellitus	242 (31.4)^b	218 (29.7)^b	142 (18.6)^d	24 (7.4)^b	6 (5.3)^b
Dyslipidemia	164 (21.3)^b	166 (22.6)^b	88 (11.5)^b	52 (16)^b	10 (8.8)
Previous cerebral infarction	164 (21.3)^b	117 (16)	146 (19.1)	31 (9.6)^b	10 (8.8)^d
Ischemic heart disease	150 (19.5)^a	104 (14.2)	163 (21.4)^b	14 (4.3)^b	4 (3.5)^b
History of transient ischemic attack	116 (15.1)^d	80 (10.9)	73 (9.6)^a	37 (11.4)	11 (9.6)
Smoking (> 20 cigarettes/d)	87 (11.3)^a	86 (11.7)^b	28 (3.7)^b	41 (12.7)^b	18 (6.9)
Chronic obstructive pulmonary disease	74 (9.6)	61 (8.3)	62 (8.1)	20 (6.2)	6 (5.3)
Peripheral vascular disease	100 (13)^d	57 (7.8)	50 (6.6)	3 (0.9)^d	4 (3.5)^d
Heart valve disease	11 (1.4)^b	21 (2.9)^b	130 (17)^b	6 (1.9)^d	6 (5.3)
Congestive heart failure	43 (5.6)	24 (3.3)^d	72 (9.4)^b	8 (2.5)^d	1 (0.9)^a
Obesity (body mass index ≥ 30 kg/m²)	36 (4.7)	47 (6.4)^b	17 (2.2)^d	13 (4)	5 (4.4)
Oral anticoagulants	18 (2.3)^a	7 (1)^b	63 (8.3)^b	2 (0.6)^b	4 (3.5)
Alcohol abuse (> 80 g/d)	26 (3.4)^a	21 (2.9)	5 (0.7)^a	10 (3.1)	4 (3.5)
Chronic liver disease	17 (2.2)	15 (2.1)	15 (2)	10 (3.1)	0
Previous intracerebral hemorrhage	9 (1.2)	9 (1.2)	7 (0.9)	6 (1.9)	1 (0.9)

Data expressed as frequencies and percentages in parentheses.

^aP < 0.05;

^bP < 0.001;

^dP < 0.01.

Table 4 Results of multivariate analysis: cardiovascular risk factors independently associated with the different subtypes of ischemic infarction in 2704 consecutive patients with cerebral infarction collected from the “Sagrat Cor Hospital of Barcelona Stroke Registry”[7]

	Odds ratio (95%CI)
Atherothrombotic infarction
Peripheral vascular disease	2.28 (1.68-3.08)
Hypertension	1.84 (1.53-2.2)
Diabetes mellitus	1.66 (1.36-2.03)
Previous transient ischemic attack	1.50 (1.16-1.95)
Chronic obstructive pulmonary disease	1.41 (1.04-1.93)
Previous cerebral infarction	1.40 (1.12-1.76)
Ischemic heart disease	1.33 (1.06-1.68)
Atrial fibrillation	0.36 (0.28-0.45)
Heart valve disease	0.23 (0.12-0.43)
Lacunar infarction
Hypertension	2.64 (2.19-3.20)
Diabetes mellitus	1.55 (1.23-1.90)
Obesity (≥ 30 kg/m²)	1.50 (1.01-2.25)
Oral anticoagulation	0.37 (0.16-0.82)
Heart valve disease	0.22 (0.17-0.28)
Cardioembolic
Atrial fibrillation	20.01 (15.98-25.05)
Heart valve disease	5.60 (3.60-8.71)
Ischemic heart disease	2.09 (1.57-2.78)
Dyslipidemia	0.69 (0.50-0.94)
Diabetes mellitus	0.68 (0.52-0.89)
Hypertension	0.67 (0.54-0.85)
Previous transient ischemic attack	0.66 (0.46-0.95)
Smoking (> 20 cigarettes/d)	0.54 (0.34-0.88)
Obesity (≥ 30 kg/m²)	0.38 (0.20-0.73)
Undetermined cause
Hypertension	0.12 (0.09-0.17)
Peripheral vascular disease	0.13 (0.04-0.41)
Atrial fibrillation	0.15 (0.10-0.23)
Diabetes mellitus	0.21 (0.13-0.32)
Ischemic heart disease	0.24 (0.13-0.42)
Heart valve disease	0.34 (0.14-0.80)
Previous cerebral infarction	0.61 (0.40-0.93)
Unusual cause
Atrial fibrillation	0.15 (0.07-0.32)
Diabetes mellitus	0.17 (0.07-0.38)
Ischemic heart disease	0.21 (0.08-0.58)
Hypertension	0.27 (0.18-0.42)

Table 5 Comparison of cardiovascular risk factors in lacunar infarction and in lacunar syndromes not due to lacunar infarcts[89] n (%)

Datos	Lacunar syndromes not due to lacunar infarction	Lacunar infarcts	P value
Total patients	146	733
Male sex	82 (56.2)	423 (57.7)	0.73
Age, yr, mean ± SD	72.9 (12.6)	74.1 (10.2)	0.285
Age ≥ 85 yr	26 (17.8)	110 (15.0)	0.393
Risk factors
Hypertension	107 (73.3)	525 (71.6)	0.683
Diabetes mellitus	31 (21.2)	218 (29.7)	0.037
Heart valve disease	10 (6.8)	21 (2.9)	0.017
Ischemic heart disease	23 (15.8)	104 (14.2)	0.623
Atrial fibrillation	44 (30.1)	81 (11.1)	0
Congestive heart failure	4 (2.7)	24 (3.3)	0.737
Previous transient ischemic attack	12 (8.2)	80 (10.9)	0.331
Previous cerebral infarction	16 (11)	117 (16)	0.123
Head traumatism	6 (4.1)	6 (0.8)	0.006
Peripheral vascular disease	17 (11.6)	57 (7.8)	0.124
Obesity (BMI ≥ 30 kg/m²)	8 (5.5)	47 (6.4)	0.671
Alcohol abuse (> 80 g/d)	7 (4.8)	21 (2.9)	0.34
Smoking (> 20 cigarettes/d)	19 (13)	86 (11.7)	0.663
Dyslipidemia	29 (19.9)	166 (22.6)	0.46

Data expressed as frequencies and percentages in parentheses.

Citation: Arboix A. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke. World J Clin Cases 2015; 3(5): 418-429
URL: https://www.wjgnet.com/2307-8960/full/v3/i5/418.htm
DOI: https://dx.doi.org/10.12998/wjcc.v3.i5.418