A cross-sectional study for risk factor model predictive for developing ischemic stroke: a clinical pharmacist’s approach

2021 ◽  
Author(s):  
Adel Sadeq ◽  
Asim Ahmed Elnour ◽  
Nadia Al Mazrouei ◽  
Mohamed Baraka
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Outcome Measure ◽  
Cross Sectional ◽  
History Of ◽  
Artery Disease

Abstract BackgroundThere is a paucity of studies in ischemic stroke in our region.Aim The aim of the current study was to delineate the potentially risk factors for the development of ischemic stroke. MethodsWe have conducted a cross-sectional hospital-based study that has enrolled 210 subjects. The subjects have had presented to the emergency department in a tertiary hospital at the United Arab Emirates. Subjects were diagnosed with ischemic stroke within 24 hours of presentation. Outcome measureThe main outcome measure was the development of ischemic stroke during indexed hospital visit.ResultsThe mean age was 47.5 ±3.2 with higher preponderance of males over females (60.9%) and 48.1% were ≥65 years. The final logistic regression model for the development of ischemic stroke contains seven variables. In descending order the seven predictive risk factors for the development of ischemic stroke were: hypertension (OR 6.1, CI 2.4-9.5; P =0.029), coronary artery disease (OR 4.2, 3.7-9.1; P =0.038), low physical activity (OR 4.2, CI 2.1-9.1; P =0.035), history of previous stroke (OR 4.1, 1.4-3.4; P =0.033), atrial fibrillation (OR 3.2, CI 2.6-8.2; P =0.017), family history of stroke (OR 3.1, 1.3-6.9; P =0.042) and diabetes mellitus (OR 2.7, CI 1.25-6.1; P =0.035). The specificity of the model was 54.2%, the sensitivity was 89.7%, and the overall accuracy was 77.3%.ConclusionIt is prudent to control the modifiable risk factors for the development of stroke such as hypertension, diabetes, atrial fibrillation, coronary artery disease and low physical activity.

scholarly journals A cross-sectional survey of Indians in Kuwait with risk factors for coronary artery disease

2019 ◽  
Vol 6 (3) ◽  
pp. 1015
Author(s):  
Sangeeta Purohit ◽  
Prashant Purohit
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Fruits And Vegetables ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Different Populations ◽  
Artery Disease

Background: The Indian sub-population is the biggest among the foreigners in Kuwait. Due to the harsh weather conditions most of the time in the year there is less inclination towards a healthy lifestyle. The present study was conducted to determine the extent of the Indian population living in Kuwait having the risk factors for coronary artery disease (CAD).Methods: A cross-sectional survey was conducted including 400 subjects aged 18 years or more (346 males and 54 females). They were subjected to general physical examination, and were asked to respond to a standard questionnaire.Results: Significantly more females than males were found to be overweight (63% vs. 43.9%, p<0.01) or obese (16.7% vs. 4.3%, p<0.005). Females also had higher proportions than males in having inadequate physical activity (79.6% vs. 53.2%, p<0.001). Significantly more males were having an inadequate intake of fruits and vegetables as compared to females (34.7% vs. 18.5%, p<0.005). There was no significant difference between the genders in proportions of hypertension, smoking, and diabetes. Overweight, hypertension, and inadequate physical activity showed a rising trend with increasing age. The studied population was compared with several geographically different populations, as well as the different populations living in India.Conclusions: As the stay and the jobs of Indians in Kuwait depend upon their health-status, prevention of CAD is of paramount importance. Looking at the levels of the prevalence of several risk factors, multilevel interventions are needed for reducing the CAD-morbidity and mortality.

scholarly journals Association between gallstone disease and ischemic stroke in Korea

2021 ◽  
Vol 26 (4) ◽  
pp. 649-655
Author(s):  
Eun Sun Gill ◽  
Young Jin Jeong ◽  
Junyong Lee
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Odds Ratio ◽  
Obstructive Coronary Artery Disease ◽  
Gallstone Disease ◽  
Smoking History ◽  
Artery Disease

Background & Objectives: In Korea, stroke incidence is projected to rise due to the rapid aging of the Korean population. Additionally, gallstone disease incidence is increasing in Korea, due to dietary and westernized lifestyle. In this cross-sectional study, we investigated the association between gallstone disease and ischemic stroke in Korea. Methods: We included 566 patients aged 40‒89 years who underwent abdominal ultrasound or abdominal computed tomography at the VHS Medical Center between January 2008 and December 2010. Patient records were reviewed for the presence of hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, obstructive coronary artery disease, and smoking history. The associations between risk factors, including gallstone disease, and ischemic stroke were analyzed using Pearson’s chi-square tests. Multiple logistic regression analysis was performed with age, sex, smoking history, hypertension, obstructive coronary artery disease, and atrial fibrillation as covariates. Results: Age, sex, hypertension, obstructive coronary artery disease, atrial fibrillation, and smoking history were identified as significant risk factors for ischemic stroke (p-value < 0.05). Gallstone disease demonstrated an unadjusted odds ratio for ischemic stroke of 2.171 (95% confidence interval, 1.264‒3.729); after adjustment for risk factors, the odds ratio was 2.015 (95% confidence interval, 1.151‒3.528). Conclusion: In Korean patients, gallstone disease and ischemic stroke are correlated. Despite an unclear causality, the risk for ischemic stroke is significantly increased in patients with gallstone disease, even after adjusting for various confounders. Clinicians should be aware of the possibility of ischemic stroke in patients with gallstone disease, and should manage and educate patients accordingly.

scholarly journals Physical activity, sedentary behavior and risk of coronary artery disease, myocardial infarction and ischemic stroke: a two-sample Mendelian randomization study

2021 ◽  
Author(s):  
Martin Bahls ◽  
Michael F. Leitzmann ◽  
André Karch ◽  
Alexander Teumer ◽  
Marcus Dörr ◽  
...  
Keyword(s):  
Physical Activity ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Sedentary Behavior ◽  
Mendelian Randomization ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Artery Disease

Abstract Aims Observational evidence suggests that physical activity (PA) is inversely and sedentarism positively related with cardiovascular disease risk. We performed a two-sample Mendelian randomization (MR) analysis to examine whether genetically predicted PA and sedentary behavior are related to coronary artery disease, myocardial infarction, and ischemic stroke. Methods and results We used single nucleotide polymorphisms (SNPs) associated with self-reported moderate to vigorous PA (n = 17), accelerometer based PA (n = 7) and accelerometer fraction of accelerations > 425 milli-gravities (n = 7) as well as sedentary behavior (n = 6) in the UK Biobank as instrumental variables in a two sample MR approach to assess whether these exposures are related to coronary artery disease and myocardial infarction in the CARDIoGRAMplusC4D genome-wide association study (GWAS) or ischemic stroke in the MEGASTROKE GWAS. The study population included 42,096 cases of coronary artery disease (99,121 controls), 27,509 cases of myocardial infarction (99,121 controls), and 34,217 cases of ischemic stroke (404,630 controls). We found no associations between genetically predicted self-reported moderate to vigorous PA, accelerometer-based PA or accelerometer fraction of accelerations > 425 milli-gravities as well as sedentary behavior with coronary artery disease, myocardial infarction, and ischemic stroke. Conclusions These results do not support a causal relationship between PA and sedentary behavior with risk of coronary artery disease, myocardial infarction, and ischemic stroke. Hence, previous observational studies may have been biased. Graphic abstract

scholarly journals Prevalence, Epidemiological Characteristics, and Pharmacotherapy of Coronary Artery Disease among Patients with Atrial Fibrillation: Data from Jo-Fib Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 605
Author(s):  
Hanna K. Al-Makhamreh ◽  
Mohammed Q. Al-Sabbagh ◽  
Ala’ E. Shaban ◽  
Abdelrahman F. Obiedat ◽  
Ayman J. Hammoudeh
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antiplatelet Agents ◽  
Retrospective Case ◽  
Increased Risk ◽  
Artery Disease ◽  
Epidemiological Characteristics ◽  
Cad Risk

Background and Objectives: Patients with AF are at increased risk for Coronary Artery Disease (CAD) owing to their shared etiologies and risk factors. This study aimed to assess the prevalence, cardiovascular risk factors, and used medications of CAD in AF patients. Materials and Methods: This retrospective, case-control study utilized data from the Jordanian Atrial Fibrillation (Jo-Fib) registry. Investigators collected clinical features, history of co-existing comorbidities, CHA2DS2-VASc, and HAS BLED scores for all AF patients aged >18 visiting 19 hospitals and 30 outpatient cardiology clinics. A multivariable binary logistic regression was used to asses for factors associated with higher odds of having CAD. Results: Out of 2000 patients with AF, 227 (11.35%) had CAD. Compared to the rest of the sample, those with CAD had significantly higher prevalence of hypertension (82.38%; p < 0.01), hypercholesterolemia (66.52%, p < 0.01), diabetes (56.83%, p < 0.01), and smoking (18.06%, p = 0.04). Patients with AF and CAD had higher use of anticoagulants/antiplatelet agents combination (p < 0.01) compared to the rest of the sample. Females had lower CAD risk than males (OR = 0.35, 95% CI: 0.24–0.50). AF Patients with dyslipidemia (OR = 2.5, 95% CI: 1.8–3.4), smoking (OR = 1.7, 95% CI: 1.1–2.6), higher CHA2DS2-VASc score (OR = 1.5, 95% CI: 1.4–1.7), and asymptomatic AF (OR = 1.9, 95% CI: 1.3–2.6) had higher risk for CAD. Conclusions: Owing to the increased prevalence of CAD in patients with AF, better control of cardiac risk factors is recommended for this special group. Future studies should investigate such interesting relationships to stratify CAD risk in AF patients. We believe that this study adds valuable information regarding the prevalence, epidemiological characteristics, and pharmacotherapy of CAD in patients with AF.

scholarly journals Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

2001 ◽  
Vol 12 (7) ◽  
pp. 1516-1523 ◽  
Author(s):  
AUSTIN G. STACK ◽  
WENDY E. BLOEMBERGEN
Keyword(s):  
United States ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
The United States ◽  
Comorbid Conditions ◽  
Clinical Correlates ◽  
History Of ◽  
Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

scholarly journals Predictive potential assessment of preoperative risk factors for atrial fibrillation in patients with coronary artery disease after coronary artery bypass grafting

2020 ◽  
Vol 35 (4) ◽  
pp. 128-136
Author(s):  
K. I. Shakhgeldyan ◽  
V. Y. Rublev ◽  
B. I. Geltser ◽  
B. O. Shcheglov ◽  
V. G. Shirobokov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Preoperative Risk ◽  
Preoperative Risk Factors ◽  
Artery Disease

Introduction. Postoperative atrial fibrillation (POAF) is one of the most common complications of coronary artery bypass grafting (CABG) and occurs in 25–65% of patients.Aim. The study aimed to assess the predictive potential of preoperative risk factors for POAF in patients with coronary artery disease (CAD) after CABG based on machine learning (ML) methods.Material and Methods. An observational retrospective study was carried out based on data from 866 electronic case histories of CAD patients with a median age of 63 years and a 95% confidence interval [63; 64], who underwent isolated CABG on cardiopulmonary bypass. Patients were assigned to two groups: group 1 comprised 147 (18%) patients with newly registered atrial fibrillation (AF) paroxysms; group 2 included 648 (81.3%) patients without cardiac arrhythmia. The preoperative clinical and functional status was assessed using 100 factors. We used statistical analysis methods (Chi-square, Fisher, Mann – Whitney, and univariate logistic regression (LR) tests) and ML tests (multivariate LR and stochastic gradient boosting (SGB)) for data processing and analysis. The models’ accuracy was assessed by three quality metrics: area under the ROC-curve (AUC), sensitivity, and specificity. The cross-validation procedure was performed at least 1000 times on randomly selected data.Results. The processing and analysis of preoperative patient status indicators using ML methods allowed to identify 10 predictors that were linearly and nonlinearly related to the development of POAF. The most significant predictors were the anteroposterior dimension of the left atrium, tricuspid valve insufficiency, ejection fraction <40%, duration of the P–R interval, and chronic heart failure of functional class III–IV. The accuracy of the best predictive multifactorial model of LR was 0.61 in AUC, 0.49 in specificity, and 0.72 in sensitivity. The values of similar quality metrics for the best model based on SGB were 0.64, 0.6, and 0.68, respectively.Conclusion. The use of SGB made it possible to verify the nonlinearly related predictors of POAF. The prospects for further research on this problem require the use of modern medical care methods that allow taking into account the individual characteristics of patients when developing predictive models.

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