Intracranial atherosclerotic disease among Saudis, prevalence, characteristics and predictors of outcome

Abstract

Intracranial Atherosclerotic Disease (ICAD) presents with high mortality and morbidity worldwide. Little is known about ICAD in Arab countries, we aim to present an extensive view of the disease burden, characteristics and outcome in Saudi Arabia. ICAD found to be dependent on ethnicity with increased risk among Asians. Since there are ethnic diversity backgrounds in Saudis this study of increased importance to explore those differences. Institutional Review Board (IRB) approval has been obtained. This ongoing investigation planning to include total of 1379 stroke patients, meanwhile the analysis was conducted on 460 patients. All stroke patients admitted to the stroke unit at National Guard Hospital, Saudi Arabia, Riyadh from February 2016 to July 2018 records were reviewed retrospectively. After excluding all hemorrhagic stroke, sinus thrombosis and stroke mimics cases, we enrolled all ischemic stroke and transient ischemic attack cases. Of 460 patients admitted with ischemic stroke, 77 (16.7%) found to have ICAD. The mean age was 61 (SD ±12) years and 304 (66.1%) were male. 293 (63.7%) patients were diabetic, 330 (71.7%) had hypertension, 176 (38.3%) were overweight and 149 (32.4%) had hyperlipidemia. Diabetes was significantly associated with ICAD (p-value=0.01). ICAD presented with high proportion of 16.7% among Saudi stroke patients. In our cohort, diabetes mellitus was the strongest predictor among ICAD patients. These findings should increase the attention of physicians to ICAD in terms of treatment, diagnosis, prognosis and clinical follow up.