Risk Factor Characterization of Ischemic Stroke Subtypes Among West Africans-Reference-Cited by-同舟云学术

Risk Factor Characterization of Ischemic Stroke Subtypes Among West Africans

Published:2022-01 Issue:1 Volume:53 Page:134-144
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Sarfo Fred S.¹^ORCID,Ovbiagele Bruce²^ORCID,Akpa Onoja³⁴,Akpalu Albert⁵^ORCID,Wahab Kolawole⁶^ORCID,Obiako Reginald⁷^ORCID,Komolafe Morenikeji⁴^ORCID,Owolabi Lukman⁸,Ogbole Godwin⁹^ORCID,Calys-Tagoe Benedict¹⁰^ORCID,Fakunle Adekunle¹¹,Sanni Taofeek¹²,Mulugeta Gebregziabher¹³^ORCID,Abdul Salaam¹⁴,Akintunde Adeseye A.¹⁵,Olowookere Samuel⁴,Uvere Ezinne O.¹¹,Ibinaiye Philip⁷^ORCID,Akinyemi Joshua⁵,Uwanuruochi Kelechukwu¹⁶^ORCID,Olayemi Balogun⁷,Odunlami Olufemi A.¹⁷,Abunimye Esther⁸^ORCID,Arulogun Oyedunni¹⁸^ORCID,Isah Suleiman Y.⁸^ORCID,Abubakar Sani A.⁷,Oladimeji Adebayo^ORCID,Adebayo Philip¹⁹,Shidali Vincent²⁰,Chukwuonye Innocent I.¹⁶^ORCID,Akpalu Josephine¹⁰^ORCID,Tito-Ilori Moyinoluwalogo M.¹¹,Asowata Osahon J.²³¹⁸,Sanya Emmanuel O.⁶,Amusa Ganiyu¹⁴^ORCID,Onyeonoro Ugochukwu¹⁶^ORCID,Ogunmodede James A.⁶^ORCID,Sule Abdullateef G.⁷,Akisanya Cynthia¹⁷^ORCID,Mensah Yaw²¹,Oyinloye Olalekan I.⁶,Appiah Lambert²²,Agunloye Atinuke M.⁵,Osaigbovo Godwin O.¹⁴,Olabinri Eunice¹²^ORCID,Kolo Philip M.⁶,Okeke Obiora¹⁶,Adeoye Abiodun M.⁵^ORCID,Ajose Olabamiji⁵,Jenkins Carolyn¹³,Lackland Daniel T.¹³^ORCID,Egberongbe Adedeji A.²³,Adeniji Olaleye¹⁷^ORCID,Ohifemen Adeleye Osimhiarherhuo¹⁷^ORCID,Tiwari Hemant K.²⁴,Arnett Donna²⁵^ORCID,Laryea Ruth Y.¹⁰,Olunuga Taiwo¹⁷,Akinwande Kazeem S.¹⁷,Imoh Lucius¹⁴,Ogah Okechukwu S.,Melikam Ezinne S.,Adebolaji Adeyemo¹⁰,Oguike Wisdom⁷,Ogunronbi Olumayowa¹⁶^ORCID,Adeniyi Wasiu¹⁷,Olugbo Obiabo Y.²⁶,Bello Abiodun H.⁶^ORCID,Ohagwu Kenneth A.¹⁶,Ogunjimi Luqman²⁷^ORCID,Agyekum Francis²⁸^ORCID,Iheonye Henry²⁹^ORCID,Adesina Julius¹⁷,Diala Samuel¹¹,Dambatta Hamisu A.⁸,Ikubor Joyce²⁵^ORCID,Singh Arti¹,Adamu Sheila²²,Obese Vida²²,Adusei Nathaniel²²,Owusu Dorcas¹^ORCID,Ampofo Michael²²,Tagge Raelle²,Efidi Richard,Fawale Bimbo⁴,Yaria Joseph,Akinyemi Rufus¹⁷^ORCID,Owolabi Mayowa¹¹^ORCID,

Affiliation:

1. Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.S., A.S., D.O.).

2. Weill Institute for Neurosciences, School of Medicine, University of California San-Francisco (B.O., O.J.A., R.T.).

3. Department of Epidemiology and Medical Statistics (O.A., O.J.A.), an College of Medicine, University of Ibadan.

4. Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria (M.K., S.O., O.A., B.F.).

5. College of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.

6. 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.).

7. Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).

8. Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).

9. Department of Radiology (G.O.), an College of Medicine, University of Ibadan.

10. Department of Medicine, University of Ghana Medical School, Accra (A.A., B.C.-T., J.A., R.Y.L.).

11. 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.

12. Federal Teaching Hospital, Ido-Ekiti, Ado-Ekiti, Nigeria (T.S., E.O.).

13. Medical University of South Carolina, Charleston (G.M., C.J., D.T.L.).

14. Jos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).

15. Ladoke Akintola University of Technology/Teaching Hospital, Ogbomosho, Nigeria (A.A.A.).

16. Federal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.)

17. 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.).

18. Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases (O.A., O.J.A.), an College of Medicine, University of Ibadan.

19. University College Hospital, Ibadan, Nigeria Aga Khan University Dar es Salaam, Tanzania (P.A.).

20. Federal Medical Centre, Keffi Zaria, Nigeria (V.S.).

21. Korle Bu Teaching Hospital, Accra, Ghana (Y.M.).

22. Komfo Anokye Teaching Hospital Kumasi, Ghana (L.A., S.A., V.O., N.A., M.A.).

23. Federal Medical Centre, Owo, Ondo State, Nigeria (A.A.E.).

24. University of Alabama at Birmingham, Alabama (H.K.T.).

25. College of Public Health, University of Kentucky (D.A., J.I.).

26. Delta State University/Delta State University Teaching Hospital, Oghara, Nigeria (O.Y.O.).

27. Department of Pharmacology and Therapeutics, Olabisi Onabanjo University. Abeokuta, Nigeria (L.O.).

28. Greater Accra Regional Hospital, Accra, Ghana (F.A.).

29. Federal Medical Centre, Lokoja, Kogi state, Nigeria (H.I.).

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Link

https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.120.032072

Reference30 articles.

1. Mohr, JP, Sacco, RL. Classification of ischemic stroke. In: Barnett, HJM, Stein, BM, Mohr, JP, Yatsu, FM, eds. Stroke: Pathophysiology, Diagnosis, and Management. Churchill Livingstone, Inc; 1992:271–283.

2. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.

3. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

4. Impact of Multiple Risk Factor Profiles on Determining Cardiovascular Disease Risk

5. Genetic Overlap Between Diagnostic Subtypes of Ischemic Stroke

Cited by 12 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Effect of a Cardiovascular Polypill on Poststroke Cognition Among Ghanaians: Secondary Analysis of a Randomized Clinical Trial;Journal of the American Heart Association;2024-08-06

2. A systematic review of the epidemiology and the public health implications of stroke in Sub-Saharan Africa;Journal of Stroke and Cerebrovascular Diseases;2024-08

3. Epigenetics as a target to mitigate excess stroke risk in people of African ancestry: A scoping review;Journal of Stroke and Cerebrovascular Diseases;2024-05

4. Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study;Journal of the Neurological Sciences;2024-04

5. Behavioural and nutritional risk factors for cardiovascular diseases among the Ghanaian population- a cross-sectional study;BMC Public Health;2024-01-16