Chung-Fen Tsai1,2,3, Niall Anderson4, Brenda Thomas3, Cathie L M Sudlow3,5. 1. Department of Neurology, Cardinal Tien Hospital, Taiwan. 2. School of Medicine, Fu Jen Catholic University, Taiwan. 3. Division of Clinical Neurosicences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. 4. Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK. 5. Institute of Genetics and Molecular Medicine (C.L.M.S), University of Edinburgh, Edinburgh, UK.
Abstract
BACKGROUND: Chinese populations are reported to have a different distribution of ischemic stroke subtypes compared with Caucasians. AIMS: To understand this better, we aimed to evaluate the differences in prevalence of risk factors in ischemic stroke and their distributions among ischemic stroke subtypes in Chinese vs. Caucasians. SUMMARY OR REVIEW: We systematically sought studies conducted since 1990 with data on frequency of risk factors among ischemic stroke subtypes in Chinese or Caucasians. For each risk factor, we calculated study-specific and random effects pooled estimates in Chinese and Caucasians separately for: prevalence among ischemic stroke; odds ratios, comparing prevalence for each ischemic stroke subtype vs. all others. We included seven studies among 16,199 Chinese, and eleven among 16,189 Caucasian ischemic stroke patients. Risk factors studied were hypertension, diabetes, atrial fibrillation, ischemic heart disease, hypercholesterolemia, smoking and alcohol. Chinese ischemic stroke patients had younger onset of stroke than Caucasians, similar prevalence of hypertension, diabetes, smoking and alcohol, and significantly lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia. Risk factor associations with ischemic stroke subtypes were mostly similar among Chinese and Caucasian ischemic stroke patients. Compared with all other ischemic subtypes, diabetes was more common in large artery stroke, atrial fibrillation and ischemic heart disease in cardioembolic stroke, and hypertension and diabetes in lacunar stroke. CONCLUSION: Our study showed a lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia in Chinese, and mostly similar risk factor associations in Chinese and Caucasian ischemic stroke patients. Further analyses of individual patient data to allow adjustment for confounders are needed to confirm and extend these findings.
BACKGROUND: Chinese populations are reported to have a different distribution of ischemic stroke subtypes compared with Caucasians. AIMS: To understand this better, we aimed to evaluate the differences in prevalence of risk factors in ischemic stroke and their distributions among ischemic stroke subtypes in Chinese vs. Caucasians. SUMMARY OR REVIEW: We systematically sought studies conducted since 1990 with data on frequency of risk factors among ischemic stroke subtypes in Chinese or Caucasians. For each risk factor, we calculated study-specific and random effects pooled estimates in Chinese and Caucasians separately for: prevalence among ischemic stroke; odds ratios, comparing prevalence for each ischemic stroke subtype vs. all others. We included seven studies among 16,199 Chinese, and eleven among 16,189 Caucasian ischemic stroke patients. Risk factors studied were hypertension, diabetes, atrial fibrillation, ischemic heart disease, hypercholesterolemia, smoking and alcohol. Chinese ischemic stroke patients had younger onset of stroke than Caucasians, similar prevalence of hypertension, diabetes, smoking and alcohol, and significantly lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia. Risk factor associations with ischemic stroke subtypes were mostly similar among Chinese and Caucasian ischemic stroke patients. Compared with all other ischemic subtypes, diabetes was more common in large artery stroke, atrial fibrillation and ischemic heart disease in cardioembolic stroke, and hypertension and diabetes in lacunar stroke. CONCLUSION: Our study showed a lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia in Chinese, and mostly similar risk factor associations in Chinese and Caucasian ischemic stroke patients. Further analyses of individual patient data to allow adjustment for confounders are needed to confirm and extend these findings.
Authors: Sheryl Hui-Xian Ng; Alex W K Wong; Cynthia Huijun Chen; Chuen Seng Tan; Falk Müller-Riemenschneider; Bernard P L Chan; M Carolyn Baum; Jin-Moo Lee; Narayanaswamy Venketasubramanian; Gerald Choon-Huat Koh Journal: Cerebrovasc Dis Date: 2019-08-21 Impact factor: 2.762
Authors: Hyung-Min Kwon; Michael J Lynn; Tanya N Turan; Colin P Derdeyn; David Fiorella; Bethany F Lane; Jean Montgomery; L Scott Janis; Zoran Rumboldt; Marc I Chimowitz Journal: JAMA Neurol Date: 2016-01 Impact factor: 18.302