BACKGROUND: Stroke etiology in ischemic stroke guides preventive measures and etiological stroke subgroups may show considerable differences between both sexes. In a population-based stroke registry we analyzed etiological subgroups of ischemic stroke and calculated sex-specific incidence and mortality rates. METHODS: The Ludwigshafen Stroke Study is a prospective ongoing population-based stroke registry. Multiple overlapping methods of case ascertainment were used to identify all patients with incident stroke or transient ischemic attack. Modified TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria were applied for subgroup analysis in ischemic stroke. RESULTS: Out of 626 patients with first-ever ischemic stroke in 2006 and 2007, women (n = 327) were older (73.5 ± 12.6 years) than men (n = 299; 69.7 ± 11.5 years; p < 0.001). The age-adjusted incidence rate of ischemic stroke was significantly higher in men (1.37; 95% CI 1.20-1.56) than in women (1.12; 95% CI 0.97-1.29; p = 0.04). Cardioembolism (n = 219; 35.0%), small-artery occlusion (n = 164; 26.2%), large-artery atherosclerosis (n = 98; 15.7%) and 'probable atherothrombotic stroke' (n = 84; 13.4%) were common subgroups of ischemic stroke. Stroke due to large-artery atherosclerosis (p = 0.025), current smoking (p = 0.008), history of smoking (p < 0.001), coronary artery disease (p = 0.0015) and peripheral artery disease (p = 0.024) was significantly more common in men than in women. Overall, 1-year survival was not different between both sexes; however, a significant age-sex interaction with higher mortality in elderly women (>85 years) was detected. CONCLUSIONS: Cardioembolism is the main source for ischemic stroke in our population. Etiology of ischemic stroke differs between sexes, with large-artery atherosclerotic stroke and associated diseases (coronary artery disease and peripheral artery disease) being more common in men.
BACKGROUND:Stroke etiology in ischemic stroke guides preventive measures and etiological stroke subgroups may show considerable differences between both sexes. In a population-based stroke registry we analyzed etiological subgroups of ischemic stroke and calculated sex-specific incidence and mortality rates. METHODS: The Ludwigshafen Stroke Study is a prospective ongoing population-based stroke registry. Multiple overlapping methods of case ascertainment were used to identify all patients with incident stroke or transient ischemic attack. Modified TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria were applied for subgroup analysis in ischemic stroke. RESULTS: Out of 626 patients with first-ever ischemic stroke in 2006 and 2007, women (n = 327) were older (73.5 ± 12.6 years) than men (n = 299; 69.7 ± 11.5 years; p < 0.001). The age-adjusted incidence rate of ischemic stroke was significantly higher in men (1.37; 95% CI 1.20-1.56) than in women (1.12; 95% CI 0.97-1.29; p = 0.04). Cardioembolism (n = 219; 35.0%), small-artery occlusion (n = 164; 26.2%), large-artery atherosclerosis (n = 98; 15.7%) and 'probable atherothrombotic stroke' (n = 84; 13.4%) were common subgroups of ischemic stroke. Stroke due to large-artery atherosclerosis (p = 0.025), current smoking (p = 0.008), history of smoking (p < 0.001), coronary artery disease (p = 0.0015) and peripheral artery disease (p = 0.024) was significantly more common in men than in women. Overall, 1-year survival was not different between both sexes; however, a significant age-sex interaction with higher mortality in elderly women (>85 years) was detected. CONCLUSIONS: Cardioembolism is the main source for ischemic stroke in our population. Etiology of ischemic stroke differs between sexes, with large-artery atherosclerotic stroke and associated diseases (coronary artery disease and peripheral artery disease) being more common in men.
Authors: Kolja M Thierfelder; Wieland H Sommer; Alena B Baumann; Ernst Klotz; Felix G Meinel; Frederik F Strobl; Konstantin Nikolaou; Maximilian F Reiser; Louisa von Baumgarten Journal: Neuroradiology Date: 2013-04-09 Impact factor: 2.804
Authors: Frederick Palm; Michael Dos Santos; Christian Urbanek; Matthias Greulich; Kathrin Zimmer; Anton Safer; Armin Jürgen Grau; Heiko Becher Journal: Eur J Epidemiol Date: 2013-02-06 Impact factor: 8.082
Authors: Amelia K Boehme; James E Siegler; Michael T Mullen; Karen C Albright; Michael J Lyerly; Dominique J Monlezun; Erica M Jones; Rikki Tanner; Nicole R Gonzales; T Mark Beasley; James C Grotta; Sean I Savitz; Sheryl Martin-Schild Journal: J Stroke Cerebrovasc Dis Date: 2014-01-25 Impact factor: 2.136
Authors: F Palm; N Henschke; J Wolf; K Zimmer; A Safer; R J Schröder; G Inselmann; C Brenke; H Becher; A J Grau Journal: J Neurol Date: 2013-06-28 Impact factor: 4.849
Authors: Christoph J Griessenauer; Sean Farrell; Atom Sarkar; Ramin Zand; Vida Abedi; Neil Holland; Andrew Michael; Christopher L Cummings; Raghu Metpally; David J Carey; Oded Goren; Neil Martin; Philipp Hendrix; Clemens M Schirmer Journal: J Cereb Blood Flow Metab Date: 2018-09-05 Impact factor: 6.200
Authors: Jan B Pietzsch; Benjamin P Geisler; Matthew J Daniels; Rachele M Busca; Giuseppe Tarantini; Lars Søndergaard; Scott E Kasner Journal: Eur Stroke J Date: 2020-09-24