Stroke in the Lehigh Valley

Friday, Gary; Lai, Sue Min; Alter, Milton; Sobel, Eugene; LaRue, Linda; Gil-Peralta, A; McCoy, Robert L.; Levitt, Lawrence P.; Isack, T.

doi:10.1212/wnl.39.9.1165

Cited by 91 publications

(40 citation statements)

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“…Similar to a recently published population-based study in a mainly white population 2 but in contrast to several older studies [7][8][9][10][11][12] that used different stroke classifications and included different ethnical groups, the present study found cardioembolism to be the most common etiology of stroke (25.6%) in our almost exclusively white study population. Cardioembolic stroke particularly dominated in the oldest age group.…”

Section: Discussionsupporting

confidence: 87%

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

Grau¹,

Weimar²,

Buggle³

et al. 2001

Stroke

865

522

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on behalf of the German Stroke Data Bank CollaboratorsBackground and Purpose-Data on risk factors for etiologic subtypes of ischemic stroke are still scant. The aim of this study was to characterize stroke subtypes regarding risk factor profile, outcome, and current treatment strategies. Methods-We analyzed data from 5017 patients with acute ischemic stroke (42.4% women, aged 65.9Ϯ14.1 years) who were enrolled in a large multicenter hospital-based stroke data bank. Standardized data assessment and stroke subtype classification were used by all centers. Results-Sex and age distribution, major risk factors and comorbidities, recurrent stroke, treatment strategies, and outcome were all unevenly distributed among stroke subtypes (PϽ0.001, respectively). Cardioembolism, the most frequent etiology of stroke (25.6%), was particularly common in the elderly (those aged Ͼ70 years) and associated with an adverse outcome, a low rate of early stroke recurrence, and frequent use of thrombolytic therapy and intravenous anticoagulation. Large-artery atherosclerosis (20.9%), the most common cause of stroke in middle-aged patients (those aged 45 to 70 years), showed the highest male preponderance, highest rate of early stroke recurrence, and highest prevalence of previous transient ischemic attack, current smoking, and daily alcohol consumption among all subtypes. The highest prevalence of hypertension, diabetes mellitus, hypercholesterolemia, and obesity was found in small-vessel disease (20.5%), which, in turn, was associated with the lowest stroke severity and mortality. Conclusions-Our results foster the concept of ischemic stroke as a polyetiologic disease with marked differences between subtypes regarding risk factors and outcome. Therefore, studies involving risk factors of ischemic stroke should differentiate between etiologic stroke subtypes. (Stroke. 2001;32:2559-2566.)

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Section: Discussionsupporting

confidence: 87%

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

Grau¹,

Weimar²,

Buggle³

et al. 2001

Stroke

865

522

View full text Add to dashboard Cite

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“…Prior studies that examined cerebrovascular disease location and the relative proportions of ischemic stroke subtypes among races included non-population-based angiogram, 20,21 carotid Doppler, 22 autopsy, 23 and hospital patient 6 -8,10 series. Despite methodological limitations, these studies have shown a higher proportion of lacunar 6 and intracranial atherosclerotic 10 stroke in blacks and Hispanics and a higher proportion of cardioembolic and extracranial atherosclerotic 7,20,22 stroke in whites. In contrast to some prior studies, 6,7,20,22 we found no significant difference in the proportion of lacunar or extracranial atherosclerotic stroke among the 3 race-ethnic groups, although the proportion of lacunar stroke was somewhat lower in whites compared with blacks and Hispanics.…”

Section: Discussionmentioning

confidence: 99%

“…Despite methodological limitations, these studies have shown a higher proportion of lacunar 6 and intracranial atherosclerotic 10 stroke in blacks and Hispanics and a higher proportion of cardioembolic and extracranial atherosclerotic 7,20,22 stroke in whites. In contrast to some prior studies, 6,7,20,22 we found no significant difference in the proportion of lacunar or extracranial atherosclerotic stroke among the 3 race-ethnic groups, although the proportion of lacunar stroke was somewhat lower in whites compared with blacks and Hispanics. Furthermore, our study, which was population based, demonstrates a greater incidence of extracranial atherosclerotic stroke in blacks than suggested by these previous, more selected series and may refute the argument that the low rates of carotid endarterectomy in blacks are caused by a low incidence of extracranial carotid disease.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics

et al. 2005

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Background-Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community. Methods and Results-A comprehensive stroke surveillance system incorporating multiple overlapping strategies was used to identify all cases of first ischemic stroke occurring between July 1, 1993, and June 30, 1997, in northern Manhattan. Ischemic stroke subtypes were determined according to a modified NINDS scheme, and age-adjusted, race-specific incidence rates calculated. The annual age-adjusted incidence of first ischemic stroke per 100 000 was 88 (95% CI, 75 to 101) in whites, 149 (95% CI, 132 to 165) in Hispanics, and 191 (95% CI, 160 to 221) in blacks. Among blacks compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85 (95% CI, 1.82 to 18.73); extracranial atherosclerotic stroke, 3.18 (95% CI, 1.42 to 7.13); lacunar stroke, 3.09 (95% CI, 1.86 to 5.11); and cardioembolic stroke, 1.58 (95% CI, 0.99 to 2.52). Among Hispanics compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00 (95% CI, 1.69 to 14.76); extracranial atherosclerotic stroke, 1.71 (95% CI, 0.80 to 3.63); lacunar stroke, 2.32 (95% CI, 1.48 to 3.63); and cardioembolic stroke, 1.42 (95% CI, 0.97 to 2.09). Conclusions-The high ischemic stroke incidence among blacks and Hispanics compared with whites is due to higher rates of all ischemic stroke subtypes.

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“…[43][44][45] Most South Asian stroke studies do not enumerate the stroke classification or type of infarction, perhaps due to limited imaging facilities in South Asian countries. This may also be explained by the limited number of population-based studies because available information is not sufficient to allow an accurate diagnosis to be made.…”

Section: Type Of Strokementioning

confidence: 99%

Ischemic Stroke in South Asians

Gunarathne

Patel

Gammon

et al. 2009

Stroke

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Background and Purpose-Within the United Kingdom, mortality from stroke is higher among South Asians compared to European whites. The reasons for this excess cerebrovascular risk in South Asians remain unclear. The aim of this review is to present a comprehensive and systematic overview of the available literature relating to ischemic stroke among South Asian populations identifying distinct features of stroke epidemiology in this group. Summary of Review-A high frequency of lacunar strokes is a familiar pattern among South Asians, which suggests a greater prevalence of small-vessel disease in South Asians. This may be a consequence of abnormal metabolic and glycemic processes. In addition, stroke mortality among South Asians appears to be explained by glycemic status, which is an independent predictor of long-term stroke mortality. Within India, there is a perceptible rural-urban gradient in stroke prevalence, underlying the dangers of the rapid transition in socioeconomic circumstances seen across the Indian subcontinent. Conclusions-This

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Stroke in the Lehigh Valley

Cited by 91 publications

References 0 publications

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

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

Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics

Ischemic Stroke in South Asians

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