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Risk Factor Characterization of Ischemic Stroke Subtypes Among West Africans.
Sarfo, Fred S; Ovbiagele, Bruce; Akpa, Onoja; Akpalu, Albert; Wahab, Kolawole; Obiako, Reginald; Komolafe, Morenikeji; Owolabi, Lukman; Ogbole, Godwin; Calys-Tagoe, Benedict; Fakunle, Adekunle; Sanni, Taofeek; Mulugeta, Gebregziabher; Abdul, Salaam; Akintunde, Adeseye A; Olowookere, Samuel; Uvere, Ezinne O; Ibinaiye, Philip; Akinyemi, Joshua; Uwanuruochi, Kelechukwu; Olayemi, Balogun; Odunlami, Olufemi A; Abunimye, Esther; Arulogun, Oyedunni; Isah, Suleiman Y; Abubakar, Sani A; Oladimeji, Adebayo; Adebayo, Philip; Shidali, Vincent; Chukwuonye, Innocent I; Akpalu, Josephine; Tito-Ilori, Moyinoluwalogo M; Asowata, Osahon J; Sanya, Emmanuel O; Amusa, Ganiyu; Onyeonoro, Ugochukwu; Ogunmodede, James A; Sule, Abdullateef G; Akisanya, Cynthia; Mensah, Yaw; Oyinloye, Olalekan I; Appiah, Lambert; Agunloye, Atinuke M; Osaigbovo, Godwin O; Olabinri, Eunice; Kolo, Philip M; Okeke, Obiora; Adeoye, Abiodun M; Ajose, Olabamiji; Jenkins, Carolyn.
Afiliação
  • Sarfo FS; Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.S., A.S., D.O.).
  • Ovbiagele B; Weill Institute for Neurosciences, School of Medicine, University of California San-Francisco (B.O., O.J.A., R.T.).
  • Akpa O; Department of Epidemiology and Medical Statistics (O.A., O.J.A.), an College of Medicine, University of Ibadan.
  • Akpalu A; Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria (M.K., S.O., O.A., B.F.).
  • Wahab K; College of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.
  • Obiako R; Department of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
  • Komolafe M; Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
  • Owolabi L; Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria (M.K., S.O., O.A., B.F.).
  • Ogbole G; Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).
  • Calys-Tagoe B; Department of Radiology (G.O.), an College of Medicine, University of Ibadan.
  • Fakunle A; Department of Medicine, University of Ghana Medical School, Accra (A.A., B.C.-T., J.A., R.Y.L.).
  • Sanni T; Department of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.
  • Mulugeta G; Federal Teaching Hospital, Ido-Ekiti, Ado-Ekiti, Nigeria (T.S., E.O.).
  • Abdul S; Medical University of South Carolina, Charleston (G.M., C.J., D.T.L.).
  • Akintunde AA; Jos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).
  • Olowookere S; Ladoke Akintola University of Technology/Teaching Hospital, Ogbomosho, Nigeria (A.A.A.).
  • Uvere EO; Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria (M.K., S.O., O.A., B.F.).
  • Ibinaiye P; Department of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.
  • Akinyemi J; Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
  • Uwanuruochi K; College of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.
  • Olayemi B; Federal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).
  • Odunlami OA; Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
  • Abunimye E; Federal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).
  • Arulogun O; Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).
  • Isah SY; Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases (O.A., O.J.A.), an College of Medicine, University of Ibadan.
  • Abubakar SA; Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).
  • Oladimeji A; Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
  • Shidali V; University College Hospital, Ibadan, Nigeria Aga Khan University Dar es Salaam, Tanzania (P.A.).
  • Chukwuonye II; Federal Medical Centre, Keffi Zaria, Nigeria (V.S.).
  • Akpalu J; Federal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).
  • Tito-Ilori MM; Department of Medicine, University of Ghana Medical School, Accra (A.A., B.C.-T., J.A., R.Y.L.).
  • Asowata OJ; Department of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.
  • Sanya EO; Weill Institute for Neurosciences, School of Medicine, University of California San-Francisco (B.O., O.J.A., R.T.).
  • Amusa G; Department of Epidemiology and Medical Statistics (O.A., O.J.A.), an College of Medicine, University of Ibadan.
  • Onyeonoro U; Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases (O.A., O.J.A.), an College of Medicine, University of Ibadan.
  • Ogunmodede JA; Department of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
  • Sule AG; Jos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).
  • Akisanya C; Federal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).
  • Mensah Y; Department of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
  • Oyinloye OI; Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
  • Appiah L; Federal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).
  • Agunloye AM; Korle Bu Teaching Hospital, Accra, Ghana (Y.M.).
  • Osaigbovo GO; Department of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
  • Olabinri E; Komfo Anokye Teaching Hospital Kumasi, Ghana (L.A., S.A., V.O., N.A., M.A.).
  • Kolo PM; College of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.
  • Okeke O; Jos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).
  • Adeoye AM; Federal Teaching Hospital, Ido-Ekiti, Ado-Ekiti, Nigeria (T.S., E.O.).
  • Ajose O; Department of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
  • Jenkins C; Federal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).
Stroke ; 53(1): 134-144, 2022 01.
Article em En | MEDLINE | ID: mdl-34587795
ABSTRACT
BACKGROUND 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 cardio-metabolic 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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: AVC Isquêmico Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Africa Idioma: En Ano de publicação: 2022 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: AVC Isquêmico Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Africa Idioma: En Ano de publicação: 2022 Tipo de documento: Article