Risk Factor Characterization of Ischemic Stroke Subtypes among West Africans

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dc.contributor.authorSarfo, F.S.,
dc.contributor.authorOvbiagele, B.,
dc.contributor.authorAkpa, O.M.
dc.contributor.authorAkpalu, A., Wahab, K.W., Obiakpo, R.,
dc.contributor.authorOgunmodede, James Ayodele
dc.contributor.authorSule, A.G.
dc.contributor.authoret al
dc.date.accessioned2023-05-21T21:20:32Z
dc.date.available2023-05-21T21:20:32Z
dc.date.issued2022
dc.description.abstractBACKGROUND AND PURPOSE: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans. METHODS: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI. RESULTS: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 427 (17.6%) large-artery atherosclerosis, 258 (10.6%) cardio-embolic, 3 (0.1%) carotid dissections, and 719 (29.6%) undetermined/other causes. The adjusted odds ratio (95% CI) for the 8 dominant risk factors for ischemic stroke were hypertension, 10.34 (6.91–15.45); dyslipidemia, 5.16 (3.78–7.03); diabetes, 3.44 (2.60–4.56); low green vegetable consumption, 1.89 (1.45–2.46); red meat consumption, 1.89 (1.45–2.46); cardiac disease, 1.88 (1.22–2.90); monthly income $100 or more, 1.72 (1.24–2.39); and psychosocial stress, 1.62 (1.18–2.21). Hypertension, dyslipidemia, diabetes were confluent factors shared by small-vessel, large-vessel and cardio-embolic subtypes. Stroke cases and stroke-free controls had a mean of 5.3±1.5 versus 3.2±1.0 adverse cardiometabolic risk factors respectively (P<0.0001). CONCLUSIONS: Traditional vascular risk factors demonstrate important differential effect sizes with pathophysiologic, clinical and preventative implications on the occurrence of ischemic stroke among indigenous West Africans.en_US
dc.identifier.citationStroke 53(1):134-44en_US
dc.identifier.urihttps://uilspace.unilorin.edu.ng/handle/20.500.12484/10613
dc.publisherAmerican Heart Associationen_US
dc.subjectKey Words: atherosclerosis ◼ dyslipidemia ◼ hypertension ◼ ischemic stroke ◼ risk factorsen_US
dc.titleRisk Factor Characterization of Ischemic Stroke Subtypes among West Africansen_US
dc.typeArticleen_US

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