ABSTRACT
BACKGROUND: Ischemic stroke is influenced by ethnic and geographical variations. The aim of this study was to identify the risk factor profiles, subtypes and recurrence of non-cardioembolic ischemic stroke for the two largest subpopulations, the Arab and South Asians, at the only stroke-admitting hospital in Qatar. METHODS: Data on stroke patients admitted to Hamad Medical Corporation from January through December 2001 were reviewed in January 2005. Only patients with non-cardioembolic ischemic stroke and complete work-up were included. RESULTS: A total of 303 patients with ischemic non-cardioembolic stroke fit the entry criteria. Sixty seven percent of the overall patient population (sex ratio 2:6, M/F) was of Arab origin, and 32% were South Asians. Hypertension was the most commonly encountered risk factor followed by dyslipidemia, diabetes mellitus, and obesity. Significant differences between the Arab and South Asian subgroup of patients were observed with respect to number of risk factors and occurrence of obesity and diabetes. Carotid artery stenotic lesions, ventricular wall motion abnormalities and stroke recurrence were observed with a higher frequency in the Arab subgroup of patients compared with the South Asians. The majority of strokes were lacunar hemispheric strokes (68%), followed by lacunar brainstem strokes (15%) and large-vessel hemispheric infarctions (10%). Patients with a previous history of stroke had a higher frequency of carotid artery stenosis (p = 0.05) and risk of stroke recurrence (p = 0.04). CONCLUSIONS: Unlike in other studies originating from the Arabian Gulf, lacunar stroke is the most common subtype of non-cardioembolic ischemic stroke in both the Arabs and South Asians in Qatar. Significant ethnic differences in age of occurrence, risk factor profile, and cardiovascular variables were observed.
Subject(s)
Intracranial Embolism/ethnology , Myocardial Ischemia/ethnology , Stroke/ethnology , Adult , Age Factors , Aged , Aged, 80 and over , Arabs , Asian People , Female , Humans , Intracranial Embolism/complications , Intracranial Embolism/epidemiology , Intracranial Embolism and Thrombosis , Male , Middle Aged , Myocardial Ischemia/complications , Myocardial Ischemia/epidemiology , Qatar/ethnology , Retrospective Studies , Risk Factors , Stroke/complications , Stroke/epidemiologyABSTRACT
OBJECTIVE: The aim of this study was to determine whether segmental left ventricular wall motion abnormalities (SLVWMA) are a potential cause of ischemic stroke. METHODS: Demographics, cardiovascular risk factors and echocardiographic parameters of patients with ischemic stroke (with and without SLVWMA) were collected and compared with those of patients who had SLVWMA but without history of ischemic stroke. RESULTS: Two hundred and fifty nine patients with ischemic stroke were identified: 187 patients without SLVWMA, and 72 with SLVWMA. The cardiac group consisted of 79 patients. Compared with the stroke patients with SLVWMA, stroke patients without SLVWMA were slightly but significantly younger (59 versus 63 years of age). Furthermore, the number of risk factors in stroke patients without SLVWMA was significantly lower compared with stroke patients with SLVWMA (2.7 versus 3.7). There was no difference in age or gender between stroke patients with SLVWMA and the cardiac patients. However, the number of risk factors was significantly higher in the cardiac patients compared with stroke patients with SLVWMA (4.4 versus 3.7). The ejection fraction was normal in both groups of stroke patients but significantly lower in the cardiac patients (37%). Significantly more lacunar ischemic strokes were observed in stroke patients with SLVWMA than in those without SLVWMA (76% versus 68%). CONCLUSION: Our data indicate that in ischemic stroke patients with multiple cardiovascular risk factors and SLVWMA a higher frequency of lacunar strokes can be found. The latter could be a marker of small-vessel disease and/or be a potential contributing factor, perhaps through a mechanism of cardiac microembolism, in the development of lacunar ischemic stroke. The mechanisms of the association between SLVWMA and lacunar ischemic stroke remain however unclear.
Subject(s)
Brain Infarction/etiology , Ventricular Dysfunction, Left/complications , Adult , Aged , Aged, 80 and over , Brain Infarction/diagnosis , Brain Infarction/epidemiology , Cross-Sectional Studies , Echocardiography , Female , Humans , Intracranial Embolism/diagnosis , Intracranial Embolism/epidemiology , Intracranial Embolism/etiology , Magnetic Resonance Imaging , Male , Middle Aged , Risk Factors , Statistics as Topic , Tomography, X-Ray Computed , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Left/epidemiologyABSTRACT
OBJECTIVE: The aim of this study was to find the association between stroke, acute myocardial infarction (AMI) and assess related risk factors such as diabetes, hypertension and atrial fibrillation. METHODS: This is a cohort study with prospective and retrospective outcomes. All patients who were hospitalised in Hamad General Hospital, Hamad Medical Corporation with stroke from January 1999 to December 2003 were included. The diagnostic classification of stroke and associated risk factors were made in accordance with the International Classification of Disease 9th revision. RESULTS: Total 377 stroke patients were treated during the five years period. The average annual incidence of stroke for 5 years was 11.7 per 100,000 population. The incidence of AMI was higher in males than in females (73.5% vs 26.5%). There was a significant difference in stroke patients with AMI in respect of their gender (p<0.001). CONCLUSION: The present study supports the hypothesis that there is a strong association between stroke, AMI and related risk factors such as diabetes, hypertension and other cardiovascular disease risk factors. Furthermore, present study showed that 60% of stroke patients had AMI and nearly 46.4% of stroke patients had diabetes mellitus.
