Abstract

Chinese have a higher stroke incidence and a different distribution of ischemic stroke (IS) subtypes as compared with Caucasians. Herein we aimed to investigate the prevalence and associations of major risk factors in IS and its subtypes in Chinese patients. From 2006 to 2011, we included 4953 acute IS patients consecutively recruited in National Taiwan University Hospital Stroke Registry (mean age 68 years; male 59%). For each risk factor, we accessed the proportion in all IS patients, and calculated odds ratios for each main IS subtype versus other subtypes. Multiple logistic regression models were used to adjust for confounders, and to examine the associations of risk factors with IS subtypes. Compared with other ischemic subtypes, large artery atherosclerotic and lacunar strokes were associated with hypertension, diabetes, and hyperlipidaemia, while cardioembolic strokes were associated with ischemic heart disease. Furthermore, the associations with hypertension and diabetes became stronger in lacunar strokes after adjusting for confounders, but not in other ischemic subtypes. Here we report the variable effects of risk factors on different IS subtypes in Chinese patients in Taiwan. Our findings could help shed light on different mechanisms of IS subtypes and provide targets to make more effective strategies for IS prevention.

Highlights

  • Chinese have a higher stroke incidence and a different distribution of ischemic stroke (IS) subtypes as compared with Caucasians

  • Our results showed that the proportions of hypertension, diabetes and hyperlipidaemia in our IS patients based in Taiwan were significantly higher, while atrial fibrillation (AF), ischemic heart disease (IHD), smoking and alcohol intake were lower than our previous meta-analyses for Caucasian ­patients[9]

  • As for the risk factor associations with IS subtypes, LAA and lacunar infarct (LI) were more associated with hypertension, diabetes, and hyperlipidemia, while CE strokes were more associated with IHD as compared with other subtypes

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Summary

Introduction

Chinese have a higher stroke incidence and a different distribution of ischemic stroke (IS) subtypes as compared with Caucasians. Further meta-analyses have shown that Chinese IS patients have similar prevalence of hypertension, diabetes, smoking and alcohol, but lower prevalence of atrial fibrillation (AF), ischemic heart disease (IHD) and hypercholesterolemia as compared with Caucasian patients, while associations of risk factors with IS subtypes were s­ imilar[9]. These findings could be confounded by age, sex, and other risk factors. We aimed to evaluate the risk factors distribution in all IS and subtypes, to assess the associations with each main IS subtype versus others using both risk-factor dependent and risk-factor free classification schemes, and to adjust for confounders

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