Etiology, Risk Factors and Sex Differences in Ischemic Stroke in the Ludwigshafen Stroke Study, a Population-Based Stroke Registry
Etiology, Risk Factors and Sex Differences in Ischemic Stroke in the Ludwigshafen Stroke Study, a Population-Based Stroke Registry
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DOI：
10.1159/000333417
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发表时间：
2012-01-01
影响因子：
2.9
通讯作者：
Grau, A. J.
中科院分区：
文献类型：
--
作者：
Palm, F.;Urbanek, C.;Grau, A. J.
背景：缺血性脑卒中的病因学指导预防措施，而病因性脑卒中亚组可能在两性之间表现出相当大的差异。在以人群为基础的卒中登记中，我们分析了缺血性卒中的病因亚组，并计算了性别特异性的发病率和死亡率。方法：路德维希港卒中研究是一项前瞻性的基于人群的卒中登记研究。采用多种重叠的病例确定方法来确定所有的卒中或短暂性脑缺血发作患者。采用改进的TOAST （Trial of Org 10172 in Acute Stroke Treatment）标准对缺血性卒中患者进行亚组分析。结果：在2006年和2007年的626例首次缺血性卒中患者中，女性（n = 327）比男性（n = 299; 69.7 +/- 11.5; p < 0.001）年龄大（73.5 +/- 12.6岁）。经年龄调整后的缺血性卒中发病率，男性（1.37;95% CI 1.20-1.56）明显高于女性（1.12;95% CI 0.97-1.29; p = 0.04）。心脏栓塞（n = 219, 35.0%）、小动脉闭塞（n = 164, 26.2%）、大动脉粥样硬化（n = 98, 15.7%）和“可能的动脉粥样硬化性卒中”（n = 84, 13.4%）是缺血性卒中的常见亚组。由大动脉粥样硬化引起的中风（p = 0.025）、吸烟史（p = 0.008）、吸烟史（p < 0.001）、冠状动脉疾病（p = 0.0015）和外周动脉疾病（p = 0.024）在男性中明显多于女性。总体而言，1年生存率在两性之间没有差异；然而，在老年妇女（50 - 85岁）中发现了显著的年龄-性别相互作用与较高的死亡率。结论：心脏栓塞是我国人群缺血性卒中的主要来源。缺血性卒中的病因因性别而异，大动脉粥样硬化性卒中及其相关疾病（冠状动脉疾病和外周动脉疾病）在男性中更为常见。版权所有(c) 2011 S. Karger AG，巴塞尔
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. Copyright (c) 2011 S. Karger AG, Basel