<span style="font-family:Verdana;">Ischemic strokes (IS), also referred to as cerebral ischemia or brain ischemia, is a significant cause to the brain cells damage or death. Approximately, 10% - 14% of...<span style="font-family:Verdana;">Ischemic strokes (IS), also referred to as cerebral ischemia or brain ischemia, is a significant cause to the brain cells damage or death. Approximately, 10% - 14% of ischemic strokes cases occurred in young adults. Hence, we conducted a meta-analysis to find the effective interventions to prevent the best strokes caused by cerebral infarction in young adults. The search was done in different databases, including Google scholar, PubMed, Embase, Medline, Cochrane Central Register of Controlled Trials, Cochrane Database, Scopus, and Web of Science from January 2016 to April 2020, and only English published articles were considered. Our analysis included studies that stratified the risk of ischemic stroke by CHA2DS2-VASc score for patients with nonvalvular atrial fibrillation. Further, random effects model was used to estimate the summary annual rate of IS. Pooled relative risks and odds ratios, with their 95% confidence intervals, were calculated, respectively. The analysis was conducted using STATA (version 12), pooled effect sizes were calculated using the random-effects model and heterogeneity was tested for using the <em>I</em><sup><em>2</em></sup> statistic. The analysis included 13 studies. The analysis shows that diabetes, high blood pressure, ischemic heart disease, atrial fibrillation, hypercholesterolemia, alcohol consumption and smoking are significant risk factors. In Caucasian and Chinese ischemic stroke patients, the risk factor associations associated with ischemic stroke subtypes are similar. Compared to all other ischemia subtypes, diabetes is more familiar with aortic stroke, atrial fibrillation, ischemic heart disease (with obstruction), hypertension and diabetes. Our research shows that atrial fibrillation, ischemic heart disease, and hypercholesterolemia are low in patients with ischemic stroke and the risk factors are higher. Further analysis of each patient’s data is required to enable confounders’ adjustments to confirm and expand these findings.</span>展开更多
Background: Stroke is a frequent medical problem and a leading cause of death and disability worldwide. Several conditions and lifestyle factors have been associated with stroke. Aim: To evaluate risk factors in strok...Background: Stroke is a frequent medical problem and a leading cause of death and disability worldwide. Several conditions and lifestyle factors have been associated with stroke. Aim: To evaluate risk factors in stroke patients in Sulaimani city. Results: 110 patients with stroke were included in this study, hypertension was found to be the most common risk factor in current study. Out of 110 cases, 83 (75.5%) were hypertensive. Peak stroke-prone age was (60 - 69) year for male, (70 - 79) year for female. We found a statistically significant relation between level of TSC, LDL with ischemic stroke (r = 0.4047, P Conclusion: Hypertension is the leading risk factor of stroke. It is therefore essential to detect and treat hypertension at its outset. High value of atherogenic index mostly associated with ischemic stroke .while no relation found with haemorhagic stroke.展开更多
Despite overwhelming evidence from large randomized clinical trials supporting a clear benefit of low-density lipoprotein cholesterol(LDL-C)lowering therapy on the primary and secondary prevention of atherosclerotic c...Despite overwhelming evidence from large randomized clinical trials supporting a clear benefit of low-density lipoprotein cholesterol(LDL-C)lowering therapy on the primary and secondary prevention of atherosclerotic cardiovascular disease,data from epidemiological and clinical observations demonstrated an increased incidence of hemorrhagic stroke in patients with low LDL-C exposure(<70 mg/dL),especially among East Asians.Meanwhile,emerging studies have reported a paradoxical phenomenon in which hypercholesterolemia is associated with better short-term outcomes in acute coronary syndrome patients,the"lipid paradox."The underlying mechanism for these two closely connected clinical observations is not clear.This review aimed to summarize the evolution and clinical implications of these two low LDL-C related concepts,and proposed a"double-hit"hypothesis that may help explain these phenomena.It is worth noting that in the era of increasing use of high-intensity LDL-C lowering and dual antiplatelet strategies in atherosclerotic cardiovascular disease in patients receiving percutaneous coronary intervention,balancing the risk of thrombosis with bleeding complication should be a priority in clinical practice.Our hypothesis may raise clinicians’awareness to identify potential high risk patients with low LDL-C(<70 mg/dL),especially among East Asians.展开更多
文摘<span style="font-family:Verdana;">Ischemic strokes (IS), also referred to as cerebral ischemia or brain ischemia, is a significant cause to the brain cells damage or death. Approximately, 10% - 14% of ischemic strokes cases occurred in young adults. Hence, we conducted a meta-analysis to find the effective interventions to prevent the best strokes caused by cerebral infarction in young adults. The search was done in different databases, including Google scholar, PubMed, Embase, Medline, Cochrane Central Register of Controlled Trials, Cochrane Database, Scopus, and Web of Science from January 2016 to April 2020, and only English published articles were considered. Our analysis included studies that stratified the risk of ischemic stroke by CHA2DS2-VASc score for patients with nonvalvular atrial fibrillation. Further, random effects model was used to estimate the summary annual rate of IS. Pooled relative risks and odds ratios, with their 95% confidence intervals, were calculated, respectively. The analysis was conducted using STATA (version 12), pooled effect sizes were calculated using the random-effects model and heterogeneity was tested for using the <em>I</em><sup><em>2</em></sup> statistic. The analysis included 13 studies. The analysis shows that diabetes, high blood pressure, ischemic heart disease, atrial fibrillation, hypercholesterolemia, alcohol consumption and smoking are significant risk factors. In Caucasian and Chinese ischemic stroke patients, the risk factor associations associated with ischemic stroke subtypes are similar. Compared to all other ischemia subtypes, diabetes is more familiar with aortic stroke, atrial fibrillation, ischemic heart disease (with obstruction), hypertension and diabetes. Our research shows that atrial fibrillation, ischemic heart disease, and hypercholesterolemia are low in patients with ischemic stroke and the risk factors are higher. Further analysis of each patient’s data is required to enable confounders’ adjustments to confirm and expand these findings.</span>
文摘Background: Stroke is a frequent medical problem and a leading cause of death and disability worldwide. Several conditions and lifestyle factors have been associated with stroke. Aim: To evaluate risk factors in stroke patients in Sulaimani city. Results: 110 patients with stroke were included in this study, hypertension was found to be the most common risk factor in current study. Out of 110 cases, 83 (75.5%) were hypertensive. Peak stroke-prone age was (60 - 69) year for male, (70 - 79) year for female. We found a statistically significant relation between level of TSC, LDL with ischemic stroke (r = 0.4047, P Conclusion: Hypertension is the leading risk factor of stroke. It is therefore essential to detect and treat hypertension at its outset. High value of atherogenic index mostly associated with ischemic stroke .while no relation found with haemorhagic stroke.
基金supported by the National Natural Science Foundation of China(Nos.81570335,81970304)a grant from Tianjin Municipal Science and Technology Commission,China(No.18ZXZNSY00290)
文摘Despite overwhelming evidence from large randomized clinical trials supporting a clear benefit of low-density lipoprotein cholesterol(LDL-C)lowering therapy on the primary and secondary prevention of atherosclerotic cardiovascular disease,data from epidemiological and clinical observations demonstrated an increased incidence of hemorrhagic stroke in patients with low LDL-C exposure(<70 mg/dL),especially among East Asians.Meanwhile,emerging studies have reported a paradoxical phenomenon in which hypercholesterolemia is associated with better short-term outcomes in acute coronary syndrome patients,the"lipid paradox."The underlying mechanism for these two closely connected clinical observations is not clear.This review aimed to summarize the evolution and clinical implications of these two low LDL-C related concepts,and proposed a"double-hit"hypothesis that may help explain these phenomena.It is worth noting that in the era of increasing use of high-intensity LDL-C lowering and dual antiplatelet strategies in atherosclerotic cardiovascular disease in patients receiving percutaneous coronary intervention,balancing the risk of thrombosis with bleeding complication should be a priority in clinical practice.Our hypothesis may raise clinicians’awareness to identify potential high risk patients with low LDL-C(<70 mg/dL),especially among East Asians.
