Effect of Major Depressive Disorder on Stroke Risk and Mortality: A Systematic Review.

This study aimed to systematically review the available data on major depressive disorder (MDD) and provide insight into how it may affect stroke risk and mortality. We conducted this systematic review drawing upon research published between July 2002 and July 2022 from the following databases: PubMed, ScienceDirect, and Google Scholar. After eliminating duplicates, screening the title and abstract, determining eligibility, and quality assessment, eight articles were left for utilization in this systematic review (one meta-analysis and seven non-randomized studies). There was a potentially significant association between MDD and stroke risk and mortality. The apparent connection between MDD and stroke has medical and public health relevance, given the high incidence, prevalence, and financial burden of MDD and stroke in the general populace. Therefore, it is imperative that further studies are conducted to confirm and validate this association between MDD and stroke while also elucidating the mechanism involved, investigating potential variables influencing this association, and contrasting MDD with conventional stroke risk factors to determine its predictive usefulness in comparison to traditional risk factors. This will have a significant effect on clinical practice since the information provided by such research will help guide essential targets for stroke prevention.

Stroke Strikes in Bangladesh: Current Insights and Future Directions.

Stroke is a neurological condition attributable to vascular injury (e.g., infarction, hemorrhage) of the central nervous system. Globally, it ranks high among the leading causes of death. The poor stroke management system in Bangladesh is contributing to the country's rapid rise in stroke incidence. Stroke-related mortality and disability can be decreased by being aware of and taking steps to address potential risk factors. The population in this area has a generally poor understanding of strokes. Important avenues for preventing stroke in this population may include an effective public awareness campaign which includes spreading knowledge regarding early signs of stroke (facial drooping, arm weakness, speech difficulties, and time), the golden hour of stroke, cardiopulmonary resuscitation, the development of structured emergency medical care, appropriate rehabilitation, control of blood pressure and blood glucose, and cessation of smoking.

Awareness of Stroke among University Employees in Kigali, Rwanda: A Cross Sectional Study

Background Awareness of stroke is important for appropriate and timely stroke prevention and management. Objective To assess the level of awareness about the risk factors, signs, and appropriate responses for stroke among university employees in Rwanda. Methods We employed a quantitative descriptive cross-sectional approach. We involved 92 participants, and a self-administered questionnaire to collect data. We computed descriptive statistics and used the Chi-Square test to assess any differences in stroke awareness. Results We found that 12% and 15.2% of the participants were not aware of any risk factor and warning sign of stroke respectively. Regarding the reaction in case a warning sign of stroke was noticed, 9.8% of the participants indicated that they would do nothing or advise the victim to take rest at home. The limited awareness was significantly higher in the administrative than academic employees for both risk factors (p=0.002) and warning signs (p=0.006), but not for the appropriate responses to stroke (p=0.426). Conclusion A significant proportion of the participants were not aware of any stroke risk factor, warning sign and appropriate responses. It is important to conduct further similar studies and implement stroke education interventions in university communities

Minimum dataset standard for cohort study of high-risk population of stroke based on regional big data platform: a consensus / 预防医学

@#A large cohort study of high-risk population of stroke based on the real world is of great significance for stroke prevention and control. However, the data element structures, variable definitions and scopes of regional big data platforms are inconsistent, which will be an obstacle for data sharing, summary, and analysis among different regions. In this study, we formed an expert consensus on a unified minimum dataset standard for the cohort study of high-risk population of stroke, considering the categories and definitions of risk factors of stroke, and the existing database of the regional big data platforms. The consensus shall provide a reference for the comparison, integration, and sharing of real world data within and between regions, and play an important role in the cohort study on risk factors of stroke, as well as the implementation and evaluation of prevention and control measures.

Decision-Making in Clinical Practice: Oral Anticoagulant Therapy in Patients with Non-valvular Atrial Fibrillation and a Single Additional Stroke Risk Factor.

Approximately 1 in 3-4 patients presenting with an ischemic stroke will also have atrial fibrillation (AF), and AF-related strokes can be effectively prevented using oral anticoagulant therapy (OAC), either with well-controlled vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs). In addition, OAC use (both VKAs and NOACs) is associated with a 26% reduction in all-cause mortality (VKAs) or an additional 10% mortality reduction with NOACs relative to VKAs. The decision to use OAC in individual AF patient is based on the estimated balance of the benefit from ischemic stroke reduction against the risk of major OAC-related bleeding [essentially intracranial hemorrhage (ICH)]. Better appreciation of the importance of VKAs' anticoagulation quality [a target time in therapeutic range (TTR) of ≥70%] and the availability of NOACs (which offer better safety compared to VKAs) have decreased the estimated threshold for OAC treatment in AF patients towards lower stroke risk levels. Still, contemporary registry-based data show that OAC is often underused in AF patients at increased risk of stroke. The uncertainty whether to use OAC may be particularly pronounced in AF patients with a single additional stroke risk factor, who are often (mis)perceived as having a "borderline" or insufficient stroke risk to trigger the use of OAC. However, observational data from real-world AF cohorts show that the annual stroke rates in such patients are higher than in patients with no additional stroke risk factors, and OAC use has been associated with reduction in stroke, systemic embolism, or death in comparison to no therapy or aspirin, with no increase in the risk of bleeding relative to aspirin. In this review article, we summarize the basic principles of stroke risk stratification in AF patients and discuss contemporary real-world evidence on OAC use and outcomes of OAC treatment in AF patients with a single additional stroke risk factor in various real-world AF cohorts.

Effects of Fluoxetine on Neural Functional Prognosis after Ischemic Stroke: A Randomized Controlled Study in China.

OBJECTIVE: We investigated the effects of fluoxetine on the short-term and long-term neural functional prognoses after ischemic stroke. METHODS: In this prospective randomized controlled single-blind clinical study in China, eligible patients afflicted with ischemic stroke were randomized into control and treatment groups. Patients in the treatment group received fluoxetine in addition to the basic therapies in the control group over a period of 90 days. The follow-up period was 180 days. We evaluated the effects of fluoxetine on the National Institutes of Health Stroke Scale (NIHSS) score and Barthel Index (BI) score after ischemic stroke through single- and multiple-factor analysis. RESULTS: The mean NIHSS score on day 180 after treatment was significantly lower in the treatment group than in the control group (P = .009). The mean BI scores on days 90 and 180 were significantly higher in the treatment group (P = .026) than in the control group (P = .011). The improvements in the NIHSS and BI scores on days 90 and 180 compared with baseline in the treatment group were all significantly greater than that in the control group (P = .033, P = .013, P = .013, P = .019, respectively). Treatment with fluoxetine was an independent factor affecting the NIHSS and BI scores on day 180 after treatment. CONCLUSION: Treatment with fluoxetine for 90 days after ischemic stroke can improve the long-term neural functional outcomes.

Gender Differences in Risk Factor and Clinical Outcome in Patients with Ischemic Stroke / 고신대학교의과대학학술지

OBJECTIVE: Gender is an important determinant for risk factors and outcomes of ischemic stroke. The aim of this study was to compare risk factors, and clinical outcomes after ischemic stroke between male and female patients. METHODS: The hospital records of patients with ischemic stroke were reviewed retrospectively. Demographic data, stroke risk factors, clinical severities and outcomes after stroke were collected and compared between male and female patients. Stroke severity and clinical disability after ischemic stroke were evaluated by means of the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) respectively. RESULTS: Among 447 patients with ischemic stroke, 195 (43.6%) patients were women. The mean age at ischemic stroke was higher in women than in men (p<0.01). As compared to men, women had a significantly lower prevalence of hyperhomocysteinemia, smoking and drinking (all p<0.01). NIHSS and mRS scores were not different between the 2 genders. CONCLUSIONS: Profiles of risk factors differed between the 2 genders, with men having a higher prevalence of hyperhomocysteinemia, smoking and drinking. There were no gender differences in stroke severity and disability after ischemic stroke.

Association between Carotid Artery Intima-Media Thickness and Stroke Risk Factors in Ischemic Stroke / 대한뇌졸중학회지

BACKGROUND: Common carotid artery intima-media thickness (IMT) is an accepted sonographic marker of early atherosclerosis, and increased IMT represents a risk of ischemic stroke. The purpose of this study was to evaluate the correlation between common carotid artery IMT and stroke risk factors in patients with ischemic stroke. METHODS: Subjects were 381 patients with acute ischemic stroke. High resolution B-mode ultrasonography was performed to measure IMT at common carotid artery. Multivariate regression analysis was performed to determine the independent factors related to common carotid artery IMT. RESULTS: The variables that strongly predicted an increase in the common carotid artery IMT were age (P <0.001) and diabetes mellitus (P <0.001). CONCLUSION: Increased common carotid artery IMT is independently associated with age and diabetes mellitus in patients with ischemic stroke.

Risk Factors of Recurrent Stroke and Taking Nursing Measure in the Elderly / 中国康复理论与实践

@#Objective To take nursing measure through analysis on the risk factors of recurrent stroke in the aged.Methods Total 96 subjects were analyzed retrospectively.The risk factors were compared on the urban and the rural through analyzing their clinical characteristics.Results There were more diabetes mellitus and blood lipid disorder and obesity in urban than those in rural.There was also a difference in hypertension between the urban and the rural.Conclusion The recurrence of stroke in the aged is owing to many factors.The different measure should be taken by different reasons.

The Metabolic Syndrome,Its Constituents and the Risk of Stroke / 国际脑血管病杂志

The metabolic syndrome (MetS) is a general name for a group of metabolic risk factors for cardiovascular diseases,and its major constituents include hyperglycemia,hypertension,lipid abnormality and central obesity.Because MetS portly overlaps the risk factors of stroke,and thus it determines that MetS is closely related with stroke.No matter the interaction of all individual risk factor or multiple risk factors may affect the occurrence and development of stroke.