Specificities of ischemic stroke risk factors in Arab-speaking countries

Abboud, H. et al. (2017) Specificities of ischemic stroke risk factors in Arab-speaking countries. Cerebrovascular Diseases, 43(3-4), pp. 169-177. (doi: 10.1159/000454776) (PMID:28199997)

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Abstract

Background: Stroke is largely preventable, and therefore, a better understanding of risk factors is an essential step in reducing the population stroke rate and resulting disease burden in Arab countries. Summary: We performed 2 separate analyses in 2 similar populations of patients with noncardioembolic ischemic stroke. This first involved 3,635 patients in the Outcomes in Patients with TIA and Cerebrovascular disease (OPTIC) registry (followed for 2 years), with baseline collection of the usual risk factors and 5 socioeconomic variables (unemployment status, residence in rural area, living in fully serviced accommodation, no health-insurance coverage, and low educational level). The second involved patients in the PERFORM trial (n = 19,100 followed up for 2 years), with baseline collection of the usual risk factors and 1 socioeconomic variable (low educational level). The primary outcome was a composite of nonfatal stroke, nonfatal myocardial infarction, or cardiovascular death. Stroke risk factors were more prevalent in patients in Arab countries. The incidence of major cardiovascular events (MACE; age- and gender-adjusted) was higher in Arab countries (OPTIC, 18.5 vs. 13.3%; PERFORM, 18.4 vs. 9.7%; both p ≤ 0.0001). These results remained significant after adjustment on risk factors and were attenuated in OPTIC after further adjustment on socioeconomic variables (hazard ratio 1.24; 95% CI 0.98-1.55; p = 0.07). Key Messages: Patients with ischemic stroke living in Arab countries had a lower mean socioeconomic status, a much higher prevalence of diabetes mellitus, and a higher rate of MACE compared with patients from non-Arab countries. This finding is partly explained by a higher prevalence of risk factors and also by a high prevalence of poverty and low educational level.

Item Type:Articles
Additional Information:This was an investigator-driven initiative and was funded by SOS-Attaque Cerebrale Association (a not-for-profit Stroke survivors Association). The OPTIC study was funded by Sanofi and the PERFORM trial was funded by Servier.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ford, Professor Ian
Authors: Abboud, H., Sissani, L., Labreuche, J., Arauz, A., Bousser, M.-G., Bryer, A., Chamorro, A., Fisher, M., Ford, I., Fox, K. M., Hennerici, M. G., Lavados, P. M., Massaro, A., Mattle, H. P., Munoz Collazos, M., Rothwell, P. M., Steg, P. G., Vicaut, E., Yamouth, B., and Amarenco, P.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Cerebrovascular Diseases
Publisher:Karger Publishers
ISSN:1015-9770
ISSN (Online):1421-9786
Published Online:15 February 2017

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