Triggers of Ischemic Stroke

Abstract

Background and Purpose-Several studies have suggested that exposure to "triggers," could precipitate the onset of ischemic stroke (IS). We performed a systematic review of the potential triggers of IS. Methods-Two independent reviewers identified studies published between January 1980 and June 2010 from MEDLINE and Embase. Where appropriate, odds ratios (ORs) were combined. Results-A total of 26 studies identified 12 potential triggers. Twenty-two studies used a case-control design, and hazard period durations ranged from 2 hours to 3 months. The majority of studies were dedicated to alcohol abuse (nϭ10) and clinical infection (nϭ12). There was a significant association between IS and alcohol abuse of Ͼ40 to 60 g within the preceding 24 hours (ORϭ2.66; 95% CI, 1.54 to 4.61) or Ͼ150 g within the previous week (ORϭ2.47; 95% CI, 1.52 to 4.02) and infection within the previous week (ORϭ2.91; 95% CI, 1.41 to 6.00) or within the previous month (ORϭ2.41; 95% CI, 1.78 to 3.27). Other triggers have been far less investigated. There was a significant association between IS and anger, heavy eating, negative or positive emotions, sudden posture change in response to a startling event, birthday, and psychological distress and no significant association with drug abuse or heavy physical exertion. Regarding methodological issues, patients were rarely blinded to study objectives, and interviewers were rarely blinded to patient status. Conclusions-Research

Preceding and Poststroke Infections in Young Adults With First-Ever Ischemic Stroke

“…A likely explanation is that the transient nature of acute infection, most of them being banal upper respiratory tract infections, acts as a temporary risk factor for stroke and extends to have effect on short-term outcome only. 3 Compared with PI, the association between PSI and adverse outcome after stroke is based on much more solid evidence. [16][17][18][19] We confirmed that young age does not protect from the deleterious effects of PSI.…”

“…[1][2][3][4][5] In some studies, preceding infections (PIs) have been linked particularly to large-vessel and cardioembolic ischemic strokes. 5,6 Also chronic infections, such as bronchial or dental infections, may have a potential to cause inflammation, to promote atherosclerosis, and to increase risk for atherothrombotic stroke.…”

“…7,8 Reported frequency of PI varies from 5.7% to 38.8%, respiratory tract infections being the most common type. [1][2][3][4][5] Patients with PI may represent a specific patient population with stroke having different response to acute ischemic injury compared with patients without PI. This might influence clinical outcome.…”

Risk factors of stroke in coastal villages of Uttara Kannada district, Karnataka, India: a case control study

“…8 Alcohol abuse, clinical infection/inflammation, recreational drug abuse, psychological distress, stressful life events, birthday, negative or positive emotions, anger, heavy physical exertion, heavy eating, sudden posture change in response to a startling event have been isolated as potential triggering factors for stroke. 9 In a study conducted in Kerala state of Southern India, key components of the metabolic syndrome and smoking are associated with ischaemic stroke in young adults. These results were similar to that observed in the current study in which High BP was found to be a risk factor for stroke.…”

Targets and abuse: the price public health campaigners pay

“…Yes Cardiovascular diseases Hypertensive heart disease, ischaemic heart disease, ischaemic stroke, haemorrhagic stroke, atrial fibrillation and flutter, conduction disorders Taylor et al, 2009;Guiraud et al, 2010;Patra et al, 2010;Samokhvalov et al, 2010c;Roerecke & Rehm, 2010a,b, 2012.…”