Abstract TP184: Impact on Ischemic Stroke Subtypes of Fasting and Non-fasting Triglycerides

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jun Yup Kim ◽  
Moon-Ku Han ◽  
Kyung Bok Lee ◽  
Keun-Sik Hong ◽  
Yong-Jin Cho ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Large Artery ◽  
Lipid Levels ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Stroke Registry ◽  
Stroke Subtypes ◽  
Clinical Research Center ◽  
Remnant Cholesterol ◽  
Overnight Fasting

Introduction: Remnant cholesterol, comprising triglycerides(TG)-rich lipoproteins, accumulates in intimal foam cells and causes atherosclerosis. Fasting TG is reported to be associated with atherosclerotic stroke, but relationships between non-fasting TG (NFTG) and ischemic stroke subtypes are unknown. Recently NFTG was found to produce endothelial dysfunction. This study aimed to elucidate the association of fasting and NFTG with ischemic stroke subtypes, especially large-artery atherosclerosis (LAA) and small vessel occlusion (SVO). Methods: Using a prospective multicenter stroke registry (Clinical Research Center for Stroke - 5th division), we identified acute ischemic stroke patients, hospitalized within 48 hours of onset, and whose fasting and non-fasting TG values were available. We measured lipid profiles in each individual twice; at presentation and after overnight fasting. Initial TG were regarded as NFTG when measured within 8 hours from last mealtime. Results: Total 3,170 patients were analyzed. Stroke subtypes were categorized as LAA (37.9%), SVO (18.7%) and non-LAA and non-SVO (43.4%). Lipid levels according stroke subtypes are presented in Table. Lipid levels were divided by quartiles and the highest quartile was compared to others. In multinomial analyses compared to non-LAA and non-SVO group, fasting TG was associated with LAA (adjusted ORs 1.33 [95% CIs 1.09 - 1.62]) and SVO (1.61 [1.27 - 2.04]). NFTG was associated not with LAA (1.05 [0.87 - 1.28]), but with SVO (1.36 [1.08 - 1.71]). With respect to other lipid levels, fasting and non-fasting LDL were associated with both LAA (1.57 [1.29 - 1.90], fasting; 1.89 [1.56 - 2.29], non-fasting) and SVO (1.40 [1.11 - 1.77], fasting; 1.74 [1.38 - 2.19], non-fasting). Conclusions: This study may be the first one to demonstrate an association between non-fasting TG and SVO. It should be explored further on mechanisms of differential effect of fasting and non-fasting TG on ischemic stroke subtypes.

Abstract TP227: Vascular Calcification, Atherosclerosis Burden, and Stroke Mechanism in Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Takashi Shimoyama ◽  
Kunio Nakamura ◽  
Sibaji Gaj ◽  
Shivakrishna Kovi ◽  
Ken Uchino
Keyword(s):  
Ischemic Stroke ◽  
Large Artery ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Vessel Occlusion ◽  
Stroke Registry ◽  
Stroke Subtypes ◽  
Toast Classification ◽  
Stroke Mechanism ◽  
Post Hoc

Background and Purpose: Calcification of the intracranial carotid artery is recognized as a risk factor for stroke in the general population. The significance of vascular calcifications in its relationship stroke mechanisms is incompletely understood. We hypothesized that vascular calcium quantification using CT angiography (CTA) can differ by stroke mechanism among ischemic stroke patients. Methods: From a prospective single-hospital stroke registry from 2018, we identified ischemic stroke patients who underwent CTA. Automatic artery and calcification segmentation method measured calcification volumes in the intracranial, extracranial, and aortic arteries using deep-learning U-net model and region-grow algorithms. Stroke subtypes were diagnosed based on the TOAST classification: large artery atherosclerosis (LAA), small vessel occlusion (SVO), cardioembolism (CE), others/undetermined. We evaluated the relationship between CTA calcification volume and stroke subtypes on one-way ANOVA and Tukey’s post-hoc test. Results: Of the 558 consecutive acute ischemic stroke patients, we enrolled 388 patients (212 males; mean age 66.6 years) in the study. Others/undetermined (34.8%) was the most frequent stroke subtype, followed by CE (29.4%), LAA (25.5%), and SVO (10.3%). The overall prevalence of atherosclerotic calcification was 95.9% in stroke patients. LAA had significantly higher calcification volume with 809 mm 3 compared to SVO (390 mm 3 , P=0.040), others/undetermined (300 mm 3 , P=0.001), but not CE (860 mm 3 , P=0.958). In age < 65 years subset, LAA showed higher calcification volume with 567 mm 3 than SVO (176 mm 3 , P=0.014), CE (213 mm 3 , P=0.021) and others/undetermined (180 mm 3 , P<0.001). There were no significant differences in calcification volume among stroke subtypes in age ≥65 years. Conclusion: Atherosclerotic calcium burden with a quantitative analysis of CTA images may be useful to differentiate stroke mechanism in younger patients.

Abstract TP207: Pre-stroke Dementia is Associated With Poor Functional Outcome After Acute Ischemic Stroke: The Fukuoka Stroke Registry

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Yoshinobu Wakisaka ◽  
Ryu Matsuo ◽  
Junya Hata ◽  
Junya Kuroda ◽  
Tetsuro Ago ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Stroke Severity ◽  
Large Artery ◽  
Stroke Patients ◽  
Poor Functional Outcome ◽  
Vessel Occlusion ◽  
Stroke Registry ◽  
Increased Risk

Introduction: With an aging population, an increased number of acute stroke patients with pre-stroke dementia is expected. Although both stroke and dementia are major cause of disability, the effect of pre-stroke dementia on functional outcome after stroke has been still on debate. Hypothesis: Pre-stroke dementia is associated with poor functional outcome after acute ischemic stroke. Methods: Of 9198 stroke patients registered in the Fukuoka Stroke Registry in Japan from June 2007 to May 2014, 3843 patients with first-ever ischemic stroke within 24h of onset, who had been functionally independent before the onset, were enrolled in this study (cardioembolism [n=926], large artery atherosclerosis [n=583], small vessel occlusion [n=1045], others [n=1289]). Pre-stroke dementia was defined as any type of dementia that was present prior to the stroke. For propensity score (PS)-matched analysis, 320 pairs of patients with and without pre-stroke dementia were also selected. Study outcome was poor functional outcome (modified Rankin Scale 3-6) at discharge. Results: In the total cohort, 330 (8.6%) had pre-stroke dementia. The age (80±8 vs 69±13, year, mean±SD, p<0.01), frequencies of female (46 vs 36, %, p<0.01) and cardioembolism (41 vs 23, %, p<0.01), and NIHSS score on admission (6 [3 - 12] vs 3 [1 - 6], median [interquartile], p<0.01) were higher in patients with pre-stroke dementia than those without the dementia. Poor functional outcome (62 vs 25, %, p<0.01) were more prevalent in patients with pre-stroke dementia than those without the dementia. Multivariable-adjusted analysis showed that pre-stroke dementia was significantly associated with increased risk for poor functional outcome (OR 2.3, 95% CI 1.7-3.2). There were no interactions between pre-stroke dementia and 4 variables (age, sex, stroke subtype, and initial stroke severity [NIHSS≤7 or NIHSS≥8]). In the PS-matched analysis, pre-stroke dementia was still associated with poor functional outcome (OR 4.3, 95%CI 2.1-8.8). Conclusions: Pre-stroke dementia was significantly associated with poor functional outcome at discharge in patients with acute ischemic stroke.

Abstract W P146: Low Serum Level of Eicosapentanoic Acid (EPA) is Associated with Occurrence of Nonlobar Type Intracerebal Hemorrhage (ICH)

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yasuhisa Akaiwa ◽  
Hiroki Takano ◽  
Hiroyuki Arakawa ◽  
Itaru Ninomiya ◽  
Masahiro Uemura ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Fatty Acids ◽  
Ischemic Stroke ◽  
Polyunsaturated Fatty Acids ◽  
Small Vessel Disease ◽  
Routine Practice ◽  
Large Artery ◽  
Omega 3 ◽  
Stroke Patients ◽  
Stroke Subtypes

Background: : Intake of omega-3 polyunsaturated fatty acids, such as EPA, has been reported to have protective effects on various diseases including ischemic stroke. However, there have been few studies concerning the effect of omega-3 polyunsaturated fatty acids on hemorrhagic stroke. We studied associations of serum levels of EPA with stroke subtypes including primary ICH Methods: We have examined serum EPA and arachidonic acid (AA) levels in routine practice since 2009. To calibrate the EPA values, we calculated EPA/AA ratio. A total of 212 consecutive acute stroke patients and 27 control subjects were included. The patients 40 years old or younger were excluded. Ischemic stroke subtypes were determined based on TOAST criteria. Primary ICH was classified into lobar or nonlobar types, according to the region of the brain in which it occurred. Results: Of all the 157 ischemic stroke patients (female 47, mean age 72.9 years), 62 were classified with cardioembolic stroke (CES), 25 large-artery atherosclerotic (LAA), 22 small-vessel disease (SVD), and 48 other/undetermined causes (O/U). Of all the 55 ICH patients (female 23, mean age 71.0), 34 patients had nonlobar type, and 21 had lobar one. There were no significant intergroup differences in the mean EPA/AA ratio (p=0.525) among CES (EPA/AA= 0.67±0.42), LAA (0.70±0.30), SVD (0.65±0.45), O/U (0.62±0.38), nonlobar ICH (0.51±0.30), lobar ICH (0.64±0.33), and control (0.60±0.42) groups. However, the EPA/AA ratio of the nonlobar ICH group was considerably low. The EPA/AA ratio of the nonlobar ICH group was significantly (p=0.033) lower than that of the whole other groups (0.65±0.39) and significantly (p=0.003) lower than that of the entire ischemic stroke groups (0.67±0.40). Although the significant differences between the nonlobar ICH and the whole ischemic groups were also observed in systolic and diastolic blood pressure (195±37/107±25 mmHg vs 159±35/82±19 mmHg, p<0.001), multiple linear regression analyses showed the association between the EPA/AA and nonlobar ICH was independent from the blood pressure. Conclusions: Although the strongest risk factor for nonlobar ICH is hypertension, low EPA/AA ratio might play a role in the development of nonlobar ICH.

scholarly journals Inconsistent centralised versus non-centralised ischaemic stroke aetiology

2020 ◽  
Vol 5 (4) ◽  
pp. 337-347
Author(s):  
Yue Suo ◽  
Jing Jing ◽  
Xia Meng ◽  
Zixiao Li ◽  
Yuesong Pan ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Ischaemic Stroke ◽  
Oral Anticoagulants ◽  
Sensitivity Analyses ◽  
Large Artery ◽  
Imaging Data ◽  
Vessel Occlusion ◽  
Stroke Treatment ◽  
Stroke Registry ◽  
Stroke Subtypes

Background and purposeThe Trial of Org 10 172 in Acute Stroke Treatment (TOAST) system is the most widely used aetiological categorisation system in clinical practice and research. Limited studies have validated the accuracy of routine aetiological diagnosis of patients with ischaemic stroke according to the TOAST criteria when the reported subtype is assumed to be correct. We investigated the agreement between centralised and non-centralised (site-reported, at discharge) stroke subtypes in the Third China National Stroke Registry (CNSR-III), and analysed the influence of classification consistency on evaluation during hospitalisation and for secondary prevention strategy.MethodsAll patients with ischaemic stroke from the CNSR-III study with complete diffusion-weighted imaging data were included. We used multivariable Cox proportional-hazard regression models to evaluate the factors associated with consistency between centralised and non-centralised stroke subtypes. Sensitivity analyses were conducted of the subgroup of patients with complete information.ResultsThis study included 12 180 patients (mean age, 62.3 years; and women, 31.4%). Agreement between centralised and non-centralised subtype was the highest for the large-artery atherosclerosis subtype stroke (77.4% of centralised patients), followed by the small-vessel occlusion subtype (40.6% of centralised patients). Agreements for cardioembolism and stroke of other determined aetiology subtypes were 38.7% and 12.2%, respectively. Patient-level and hospital-level factors were associated with the inconsistency between centralised/non-centralised aetiological subtyping. This inconsistency was related to differences in secondary prevention strategies. Only 15.3% of the newly diagnosed patients with cardioembolism underwent centralised subtyping with indications to receive oral anticoagulants at discharge. In comparison, 51.3% of the consistent cardioembolism group and 42.0% of the centrally reassigned cardioembolism group with anticoagulation indications were prescribed oral anticoagulants.ConclusionsSubstantial inconsistency exists between centralised and non-centralised subtyping in China. Inaccurate aetiological subtyping could lead to inadequate secondary prevention, especially in patients with cardioembolic stroke.

Abstract P84: Covid-19 and Stroke in the Latin American Stroke Registry (LASE)

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Virginia Pujol-Lereis ◽  
Alan F Flores ◽  
Antonio Arauz ◽  
Carlos Abanto ◽  
Pablo Amaya ◽  
...  
Keyword(s):  
Latin America ◽  
Ischemic Stroke ◽  
Latin American ◽  
Clinical Characteristics ◽  
Hemorrhagic Stroke ◽  
Reperfusion Therapy ◽  
Infection Frequency ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Stroke Registry

Background: Ischemic stroke has been reported to occur in approximately 5% of COVID-19 patients, although some reports are contradictory. Proposed mechanisms of this association are hypercoagulable state, vasculitis and cardiomyopathy, together with traditional vascular risk factors. We analyzed the frequency and clinical characteristics of COVID-19 positive stroke cases during the first months of the pandemic in Latin America. Methods: A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March - June 2020). We assessed acute stroke cases associated to COVID-19 infection. Clinical characteristics, stroke etiology and severity, acute care and functional outcomes, were compared between non-COVID-19 and COVID-19 cases. Results: There were a total of 1037 stroke cases; sixty-two of them (6.0%) were diagnosed with COVID-19 infection. This group consisted of 38 men [61.3%], with a median age of 68 years [IQR 59-79 years]. From these cases, 80.6% were ischemic stroke, 16.1% hemorrhagic stroke, and 1.6% transient ischemic attack and cerebral venous thrombosis respectively. The most common etiology reported for ischemic cases was atherosclerotic large vessel occlusion (30.6% vs. 12.7% in non-COVID cases, p<0.001), and undetermined etiology for hemorrhagic stroke (55.6%). Median NIHSS for COVID-stroke patients was higher (7 IQR 2-16 vs. 5 IQR 2-11, p=0.05). Five (8.1%) patients received acute reperfusion therapy, with no differences in door-to-CT, door-to-needle and door-to-groin times, compared to non-COVID cases. Most characteristics did not differ from those of COVID-19 negative patients. Mortality was higher in COVID-stroke cases (20.9% vs. 9.6%, p<0.001). Conclusions: COVID-19 infection frequency in stroke patients in Latin America is similar to that reported in several series worldwide, with a higher frequency of atherosclerotic ischemic strokes and mortality compared to non COVID-19 strokes

Abstract W P192: Echocardiographic findings in Acute Ischemic Stroke are Implicated in Specific Subtypes of Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Jun Lee ◽  
Jung-Im Kwon ◽  
Na-Young Kim ◽  
Hyun-Du Noh
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Demographic Data ◽  
Left Ventricular ◽  
Volume Index ◽  
Large Artery ◽  
Vessel Occlusion ◽  
Stroke Subtypes ◽  
Echocardiographic Findings

Background & Significance: Echocardiographic left ventricular hypertrophy (LVH) and left atrial enlargement (LAE) reflect mortality and morbidity from cardiovascular disease. We aimed to investigate the association between echocardiographic findings and stroke subtypes and its implication in acute ischemic stroke. Methods: We retrospectively reviewed the records of 1692 patients with acute ischemic stroke, who were admitted within 7 days after symptom onset. Stroke subtypes were categorized according to the SSS-TOAST classification. LVH was defined as left ventricular mass index (LVMI) >115 g/m2 in men and >95 g/m2 in women, and moderate to severe LAE was defined as left ventricular volume index (LAVi) ≥34 ml/m2 in both gender. The demographic data and echocardiographic findings [LVMI, LAVi, and left atrial anterior-posterior diameter (LAD) and presence of LVH or LAE] were compared in each stroke subtype. Results: A total of 1002 patients who were classified as patients with large-artery atherosclerosis (LAA, n=525), patients with cardioembolism (CE, n=296), and patients with small vessel occlusion (SVO, n=181) were included. Echocardiographic variables showed trends in which larger LVMI, LAD, and LAVi in CE group compared with two other groups. Multivariate analysis was performed as comparison with SVO after adjusting for age, gender, hyperlipidemia, diabetes mellitus, and history of smoking. LVH and LVMI were significant independent predictors of LAA (OR 1.6, 95%CI 1.0-2.5, p=0.04 in LVH and OR 1.1, 95%CI 1.0-1.2 by increased LVMI 10g/m2, p=0.036), and all of moderate-to-severe LAE, LVH, LVMI, LAD and LAVi were significant independent predictors of CE (OR 16.7, 95%CI 8.3-33.7, p<0.001 in LAE; OR 2.4, 95%CI 1.5-3.8, p<0.001 in LVH; OR 1.2, 95%CI 1.11-1.3 by increased LVMI 10g/m2, p<0.001; OR 1.2, 95%CI 1.1-1.2 by increased LAD 1 mm, p<0.001; OR 1.2, 95%CI 1.1-1.2 by increased LAVi 1 ml/m2, p<0.001). Conclusions: Our studies demonstrate echocardiographic LVMI, LAD and LAVi are linked to specific stroke subtypes even after adjusting for established cardiovascular risk. These results suggest that consideration of echocardiographic indices is helpful to understand the pathomechanism in the ischemic stroke.

scholarly journals Risk Factors and Etiologies of Ischemic Stroke in Young Adults: A Hospital-based Study in Bangladesh

2018 ◽  
Vol 8 (2) ◽  
pp. 138-144
Author(s):  
Rumana Habib ◽  
Ikram Hosen ◽  
Rashedul Islam ◽  
Nirmalendu Bikash Bhowmik
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Internal Capsule ◽  
Large Artery ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Stroke In Young Adults ◽  
Subcortical Region ◽  
Associated Risk Factors

Background: Stroke is an important cause of disability among adults and is one of the leading causes of death worldwide. Strokes in young adults can have a significant impact on the affected individuals, their families and societies in general as the affected patients are in the economically productive period of their lives.This study was aimed to find out the demographic profile and explore the associated risk factors of the first-ever ischemic stroke of young adults.Methods: This retrospective study reviewed the records of 64 patients, age 18-49 years, ischemic stroke patients consecutively admitted in the Neurology department, BIRDEM General Hospital during the period January 2016 to June 2017. Study variables included hematological and biochemistry investigations and radiological and imaging findings. Stroke sub-typing was done following to TOAST criteria. Data of follow-up data at 3 month were also included. Data were expressed as number (percent) and managed by SPSS for Windows Version 15.Results: Of the 634 patients diagnosed as acute ischemic stroke 64 (9.90%) were in the 18-49 (yr) age range and the majority (55.4%) were male. Stroke was more common (47 out of 54) among the 31-49 years category as compare with the <30 years category. Stroke patients presented with diabetes mellitus(87.03%),arterial hypertension (44.4%), dyslipidemia (23.5%) and cigarette smoking (31.48%). Family history of stroke was present in 33.5% cases. Ten (6.51%) patients showed hypercoagualable state.Small vessel occlusion (SVO) found in 48.40% cases followed by large artery atherosclerosis (21.86%).Patients with SVO stroke presented with lacunar syndromes and lesions in Basal ganglia(12.1%),Thalamus(6.6%), Subcortical region (0.9%),Internal capsule (20.0%)and brain stem(11.3%). Thrombolysis was not done in any of patients. Most of the patients were on an anti-platelet treatment and majority (85.4%) receiving aspirin alone. Strokes left 48(75.5%)patients with moderate to moderately severe disability on discharge from the hospital.Mortality was lower (6.3%) and had good recovery 35 (54.6%).Conclusion: Ischemic stroke in the young adults accounted for 9.90% of the hospital admission with stroke. Those suffered from ischemic stroke had presence of modifiable risk factors. Predominance of SVO among them not only indicated stroke etiology but also predicted good short term prognosis.Birdem Med J 2018; 8(2): 138-144

High five-year mortality rates of ischemic stroke subtypes: A prospective cohort study in Brazil

2018 ◽  
Vol 14 (5) ◽  
pp. 491-499 ◽  
Author(s):  
Norberto Luiz Cabral ◽  
Vivian Nagel ◽  
Adriana B Conforto ◽  
Pedro SC Magalhaes ◽  
Vanessa G Venancio ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Survival Probability ◽  
Recurrent Stroke ◽  
Mortality Rates ◽  
Large Artery ◽  
Small Artery ◽  
Stroke Patients ◽  
Stroke Subtypes ◽  
Artery Disease

Background Studies regarding long-term outcomes of ischemic stroke subtypes are scarce in low- and middle-income countries. We aimed to measure the five-year prognosis of ischemic stroke subtypes in Joinville, Brazil. Methods All first-ever ischemic strokes that occurred in Joinville in 2010 were followed-up for five years. Results We included 334 ischemic stroke patients. Over five years, 156 died, 51 had a recurrent stroke, and 128 were free of recurrent stroke. The overall cumulative risk of death was 17% (95% CI, 13% to 22%) at 30 days and 47% (95% CI, 41% to 52%) after five years. Undetermined with incomplete investigation ischemic stroke had a significantly worse survival probability (β −4.91; 95% CI, −6.31 to −3.50; p < 0.001), followed by cardioembolic ischemic stroke (β −3.07; 95% CI, −4.32 to −1.83; p < 0.001) and large artery disease ischemic stroke (β −1.95; 95% CI, −3.30 to −0.60; p = 0.005). The survival probability of undetermined with negative investigation or cryptogenic ischemic stroke did not differ significantly from small artery disease ischemic stroke (β −1.022; 95% CI, −3.37 to −1.43; p = 0.414). The five-year mortality for small artery disease ischemic stroke was 30% (95% CI, 22% to 39%) and 47% (95% CI, 35% to 60%) for large artery ischemic stroke. The risk of stroke recurrence was 2% in the first year and 5% in the second year. The proportion of disability among survivors in the first month ranged from 8% (95% CI, 3–15) for small artery disease ischemic stroke to 40% (95% CI, 30–52) for cardioembolic ischemic stroke patients. Conclusions Cardioembolic and undetermined with incomplete investigation ischemic stroke sub-types have a poor long-term prognosis. An alarming finding was that our patients with both small and large artery ischemic stroke had higher five-year mortality rates compared with subjects from high-income countries.

scholarly journals Stroke recurrence in the different subtypes of ischemic stroke. The importance of the intracranial disease

2018 ◽  
Vol 76 (10) ◽  
pp. 649-653 ◽  
Author(s):  
Marcos C Lange ◽  
Gustavo Ribas ◽  
Valeria Scavasine ◽  
Renata Dal-Prá Ducci ◽  
Danielle C. Mendes ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Recurrence Rate ◽  
Brazilian Population ◽  
Stroke Recurrence ◽  
Large Artery ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Undetermined Etiology ◽  
Stroke Mechanism

ABSTRACT The aim of the study was to analyze the long-term recurrence rate in patients with a first-ever ischemic stroke secondary to intracranial large artery atherosclerosis (LAA) in a Brazilian population. Methods: All stroke patients admitted to the hospital between October 2012 and September 2015 were evaluated. The stroke mechanism subtypes were classified as cardioembolism, LAA, small-vessel occlusion, other determined etiologies, and stroke of undetermined etiology. Results: The 359 first-ever ischemic stroke patients were followed up for a mean time of 21.6 ± 15.1 months. The LAA intracranial (38.9%) and extracranial (24.6%) stroke patients presented with a higher stroke recurrence. Intracranial LAA [HR, 10.2 (3.6–29.1); p < 0.001] and extracranial LAA [HR, 5.05 (1.79–14.2); p = 0.002] were the only conditions to show positive correlation with the recurrence rate, after adjusting for risk factors, thrombolysis, and National Institutes of Health Stroke Scale score at admission. Conclusion: Intracranial LAA presents a higher incidence of recurrence of ischemic stroke when compared with other etiologies in a Southern Brazilian population.

Abstract TP206: Effects of Smoking Status on the Onset Age of the First-Ever Stroke: Data From Korean Stroke Registry

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Han-yeong Jeong ◽  
Heejung Mo ◽  
Chan-Hyuk Lee ◽  
Min Kyoung Kang ◽  
Eung-Joon Lee ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Smoking Status ◽  
Age At Onset ◽  
Large Artery ◽  
Onset Age ◽  
Vessel Occlusion ◽  
Stroke Registry ◽  
The Mean ◽  
Never Smokers ◽  
The Impact

Background: There is evidence that smoking increases stroke risk. However, the impact of smoking status on age at onset of ischemic stroke has not been studied. The aim of this study is to explore the effect of smoking status on the age at onset of first-ever ischemic stroke using the Korean Stroke Registry(KSR), the nation-wide, multicenter, hospital-based stroke registry in Republic of Korea. Methods: This study used individual data of first-ever ischemic stroke patients from the KSR, between 2014 and 2018. We divided the patients into four groups according to their smoking status; current smokers, past-smokers - quit in recent 5 years, past smokers - quit over than 5 years, and never-smokers. Results: A total of 27,942 patients were included in the analysis. The mean age at onset of the first-ever stroke were 60.0±11.9 in current smokers, 65.9±11.9 past-smokers - quit in recent 5 years, 70.1±10.8 in past smoker - quit over than 5 years, and 70.5±12.8 in never-smokers (p<0.001). In the stroke subtypes analysis, the mean age at onset of the first-ever stroke were 60.9±12.5, 66.7±11.2, 70.7±10.8, and 71.1±11.9 in large artery atherosclerosis group, 58.8±10.8, 63.8±11.1, 68.2±10.4, and 68.6±12.0 in small vessel occlusion group, and 64.1±11.9, 67.7±11.6, 71.8±10.3, and 73.8±11.4 in cardioembolism group, respectively (all p<0.001). Conclusions: The smoking status of patients was associated with an earlier onset age of the first-ever stroke. The onset age tends to be delayed with the longer duration of cessation period.

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