The burden, risk factors and unique etiologies of stroke in South-East Asia Region (SEAR)

Pandian, Jeyaraj D.; Padma Srivastava, Madakasira Vasantha; Aaron, Sanjith; Ranawaka, Udaya K.; Venketasubramanian, Narayanaswamy; Sebastian, Ivy Anne; Injety, Ranjit J.; Gandhi, Dorcas B.C.; Chawla, Nistara S.; Vijayanand, Pranay J.; Rangamani, Sukanya; Kalkonde, Yogeshwar V.

doi:10.1016/j.lansea.2023.100290

Cited by 10 publications

(3 citation statements)

References 56 publications

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“…4 As another example, South-East Asians, accounting for more than 40% of global stroke mortality, have a relatively higher mean blood pressure, with hypertension being the most prevalent risk factor, suggesting a focus on raising awareness and treatment adherence to hypertension in this population. 5,6 These cases suggest that detailed assessments of risk factors in various regions is necessary to develop regionspecific tailored approaches for stroke prevention. 7 However, because previous studies had limited access to individual data, there remains a need to more rigorously demonstrate the presence of regional differences in stroke incidence and subtype.…”

Section: Introductionmentioning

confidence: 99%

Racial Differences in Ischemic and Hemorrhagic Stroke: An Ecological Epidemiological Study

Kang,

Yang,

Kim

et al. 2024

Thromb Haemost

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Background: This study aimed to evaluate racial differences in the incidence of stroke by conducting an ecological epidemiological study using UK Biobank and Korean nationwide data. Methods: This study used patient-level data from the Korean National Health Insurance Service-Health Screening and UK Biobank, which included participants who underwent health examinations between 2006 and 2010. We included 112,750 East Asians (50.7% men, mean age 52.6 years) and 210,995 Caucasians (44.7% men, mean age 55.0 years) who were not diagnosed with atrial fibrillation, cardiovascular diseases, chronic kidney disease, chronic obstructive pulmonary disease, or cancer. The primary outcome was defined as a composite of ischemic and hemorrhagic stroke. Results: East Asians tended to have a lower body mass index (23.7 kg/m2 vs. 26.4 kg/m2, P < 0.001) and a higher proportion of participants who did not engage in moderate-to-vigorous physical activity (49.6% vs. 10.7%, P < 0.001) than Caucasians. During the follow-up, East Asians had higher five-year incidence rates (presented as per 1000 person-years) for primary outcome (1.73 vs. 0.50; incidence rate ratio [IRR] 3.48, 95% confidence interval [CI] 3.13–3.88), ischemic stroke (1.23 vs. 0.33; IRR 3.70, 95% CI 3.25–4.21), hemorrhagic stroke (0.56 vs. 0.18; IRR 3.20, 95% CI 2.67–3.84), and atrial fibrillation-related stroke (0.19 vs. 0.09; IRR 2.04, 95% CI 1.55–2.68). Conclusions: Based on this ecological epidemiological study, racial differences in stroke incidence were robust to a variety of statistical analyses, regardless of the subtype. This suggests the need for region-specific approaches to stroke prevention

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Section: Introductionmentioning

confidence: 99%

Racial Differences in Ischemic and Hemorrhagic Stroke: An Ecological Epidemiological Study

Kang,

Yang,

Kim

et al. 2024

Thromb Haemost

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“…It is a significant healthcare challenge worldwide, and its impact is particularly pronounced in developing nations like India. Limited healthcare resources, disparities in access to care, and unique demographic and epidemiological factors exacerbate the burden of ICH in these regions [ 3 ]. Understanding factors influencing ICH patient outcomes is crucial for optimizing clinical management, risk stratification, and resource allocation.…”

Section: Introductionmentioning

confidence: 99%

Prognostic biomarkers of intracerebral hemorrhage identified using targeted proteomics and machine learning algorithms

Misra,

Kawamura,

Singh

et al. 2024

PLoS ONE

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Early prognostication of patient outcomes in intracerebral hemorrhage (ICH) is critical for patient care. We aim to investigate protein biomarkers’ role in prognosticating outcomes in ICH patients. We assessed 22 protein biomarkers using targeted proteomics in serum samples obtained from the ICH patient dataset (N = 150). We defined poor outcomes as modified Rankin scale score of 3–6. We incorporated clinical variables and protein biomarkers in regression models and random forest-based machine learning algorithms to predict poor outcomes and mortality. We report Odds Ratio (OR) or Hazard Ratio (HR) with 95% Confidence Interval (CI). We used five-fold cross-validation and bootstrapping for internal validation of prediction models. We included 149 patients for 90-day and 144 patients with ICH for 180-day outcome analyses. In multivariable logistic regression, UCH-L1 (adjusted OR 9.23; 95%CI 2.41–35.33), alpha-2-macroglobulin (aOR 5.57; 95%CI 1.26–24.59), and Serpin-A11 (aOR 9.33; 95%CI 1.09–79.94) were independent predictors of 90-day poor outcome; MMP-2 (aOR 6.32; 95%CI 1.82–21.90) was independent predictor of 180-day poor outcome. In multivariable Cox regression models, IGFBP-3 (aHR 2.08; 95%CI 1.24–3.48) predicted 90-day and MMP-9 (aOR 1.98; 95%CI 1.19–3.32) predicted 180-day mortality. Machine learning identified additional predictors, including haptoglobin for poor outcomes and UCH-L1, APO-C1, and MMP-2 for mortality prediction. Overall, random forest models outperformed regression models for predicting 180-day poor outcomes (AUC 0.89), and 90-day (AUC 0.81) and 180-day mortality (AUC 0.81). Serum biomarkers independently predicted short-term poor outcomes and mortality after ICH. Further research utilizing a multi-omics platform and temporal profiling is needed to explore additional biomarkers and refine predictive models for ICH prognosis.

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“…In a series of papers published in this issue of The Lancet Regional Health—Southeast Asia, a team of researchers led by Prof Jeyarani Pandian, World Stroke Organisation President Elect, set out to present current data and data gaps on the stroke burden, systems of care, and surveillance in the Southeast Asia Region (SEAR). 2 , 3 , 4…”

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confidence: 99%

Knowledge is power

Ranta

2023

The Lancet Regional Health - Southeast Asia

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The burden, risk factors and unique etiologies of stroke in South-East Asia Region (SEAR)

Cited by 10 publications

References 56 publications

Racial Differences in Ischemic and Hemorrhagic Stroke: An Ecological Epidemiological Study

Racial Differences in Ischemic and Hemorrhagic Stroke: An Ecological Epidemiological Study

Prognostic biomarkers of intracerebral hemorrhage identified using targeted proteomics and machine learning algorithms

Knowledge is power

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