RACE ETHNICITY AND DETERMINANTS OF INTRACRANIAL ATHEROSCLEROTIC CEREBRAL INFARCTION - THE NORTHERN MANHATTAN STROKE STUDY
RACE ETHNICITY AND DETERMINANTS OF INTRACRANIAL ATHEROSCLEROTIC CEREBRAL INFARCTION - THE NORTHERN MANHATTAN STROKE STUDY
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DOI：
10.1161/01.str.26.1.14
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发表时间：
1995-01-01
期刊：
影响因子：
8.3
通讯作者：
ZAMANILLO, MC
中科院分区：
文献类型：
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作者：
SACCO, RL;KARGMAN, DE;ZAMANILLO, MC
背景和目的-这项调查的目的是确定种族的重要性作为颅内动脉粥样硬化性卒中的一个决定因素，在社区为基础的中风sample.Methods居民从北方曼哈顿39岁以上的急性缺血性卒中住院（n=438，黑人35%，西班牙裔46%，白色19%）进行了前瞻性评估。指数缺血性卒中分为动脉粥样硬化（17%）、腔隙性（30%）、心源性（21%）、隐源性（31%）和其他（1%）。动脉粥样硬化性梗死被细分为颅外（9%）和颅内（8%）atherosclerosis.Results颅外动脉粥样硬化性卒中的比例是相似的三个种族，种族群体，而颅内动脉粥样硬化更常见于黑人和西班牙裔。非白人（黑人和西班牙裔合并）颅外动脉粥样硬化的未校正比值比为0.8（置信区间[CI]，0.4 - 1.8），颅内动脉粥样硬化的未校正比值比为7.8（CI，1.04 - 57.7）。与非动脉粥样硬化性疾病患者相比，颅内疾病患者明显更年轻，高胆固醇血症和胰岛素依赖型糖尿病的发生率更高。非白人种族与颅内动脉粥样硬化相关的优势比降低到5.2（CI，0.7至40）控制年龄后至4.4（CI，0.6 - 35）在控制年龄、教育、胰岛素依赖型糖尿病、结论：来自北方曼哈顿的黑人和西班牙裔人中糖尿病和高胆固醇血症的患病率较高，颅内动脉粥样硬化性中风的发病率增加。进一步控制这些危险因素可以降低这种卒中亚型的频率，并最大限度地减少不同种族-民族群体之间的差异。
Background and Purpose The aim of this investigation was to determine the importance of race as a determinant of intracranial atherosclerotic stroke in a community-based stroke sample.Methods Residents from northern Manhattan over age 39 years hospitalized for acute ischemic stroke (n=438, black 35%, Hispanic 46%, white 19%) were prospectively evaluated. Index ischemic strokes were classified as atherosclerotic (17%), lacunar (30%), cardioembolic (21%), cryptogenic (31%), and other (1%). Atherosclerotic infarcts were subdivided into extracranial (9%) and intracranial (8%) atherosclerosis.Results The proportion of extracranial atherosclerotic stroke was similar among the three race-ethnic groups, while intracranial atherosclerosis was more frequent in blacks and Hispanics. The unadjusted odds ratio for nonwhites (blacks and Hispanics combined) was 0.8 (confidence interval [CI], 0.4 to 1.8) for extracranial and 7.8 (CI, 1.04 to 57.7) for intracranial atherosclerosis. Patients with intracranial disease were significantly younger and had an increased frequency of hypercholesterolemia and insulin-dependent diabetes compared with those with nonatherosclerotic disease. The odds ratio for the association of nonwhite race-ethnicity and intracranial atherosclerosis was reduced to 5.2 (CI, 0.7 to 40) after controlling for age and to 4.4 (CI, 0.6 to 35) after controlling for age, education, insulin-dependent diabetes, and hypercholesterolemia.Conclusions The greater prevalence of diabetes and hypercholesterolemia among blacks and Hispanics from northern Manhattan accounted for much of the increased frequency of intracranial atherosclerotic stroke. Further control of these risk factors could reduce the frequency of this stroke subtype and minimize the disparities among different race-ethnic groups.