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Author: search.filters.author.Ayrton MassaroSubject: search.filters.subject.epidemiology

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    Demographics, Socio-Economic Characteristics, and Risk Factor Prevalence in Patients with Non-Cardioembolic Ischaemic Stroke in Low- and Middle-Income Countries: The OPTIC Registry
    (2012)
    Halim Abboud
    ;
    Julien Labreuche
    ;
    Antonio Arauz
    ;
    Alan Bryer
    ;
    Pablo G Lavados
    <jats:sec><jats:title>Background</jats:title><jats:p> There is a paucity of data on patients with stroke/transient ischaemic attack in low- and middle-income countries. We sought to describe the characteristics and management of patients with an ischaemic stroke and recent transient ischaemic attack or minor ischaemic strokes in low- or middle-income countries. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> The Outcomes in Patients with TIA and Cerebrovascular disease registry is an international, prospective study. Patients ≥45 years who required secondary prevention of stroke (either following an acute transient ischaemic attack or minor ischaemic strokes (National Institutes of Health Stroke Scale &lt;4) of &lt;24 h duration, or recent (&lt;6 months), stable, first-ever, non-disabling ischaemic stroke) were enrolled in 17 countries in Latin America, the Middle East, and Africa. The main measures of interest were risk factors, comorbidities, and socio-economic variables. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Between January 2007 and December 2008, 3635 patients were enrolled in Latin America ( n =1543), the Middle East ( n =1041), North Africa ( n = 834), and South Africa ( n = 217). Of these, 63% had a stable, first-ever ischaemic stroke (median delay from symptom onset to inclusion, 25 days interquartile range, 7–77); 37% had an acute transient ischaemic attack or minor ischaemic stroke (median delay, two-days; interquartile range, 0–6). Prevalence of diabetes was 46% in the Middle East, 29% in Latin America, 35% in South Africa, and 38% in North Africa; 72% had abdominal obesity (range, 65–78%; adjusted P &lt; 0·001); prevalence of metabolic syndrome was 78% (range, 72–84%, P &lt; 0·001). Abnormal ankle brachial index (&lt;0·9) was present in 22%, peripheral artery disease in 7·6%, and coronary artery disease in 13%. Overall, 24% of patients had no health insurance and 27% had a low educational level. </jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p> In this study, patients in low- and middle-income countries had a high burden of modifiable risk factors. High rates of low educational level and lack of health insurance in certain regions are potential obstacles to risk factor control. </jats:p></jats:sec><jats:sec><jats:title>Funding</jats:title><jats:p> The Outcomes in Patients with TIA and Cerebrovascular disease registry is supported by Sanofi-Aventis, Paris, France. </jats:p></jats:sec>
      5Scopus© Citations 24
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    Item type:Publication,
    Impact of living and socioeconomic characteristics on cardiovascular risk in ischemic stroke patients
    (2014)
    Pierre Amarenco
    ;
    Halim Abboud
    ;
    Julien Labreuche
    ;
    Antonio Arauz
    ;
    Alan Bryer
    <jats:sec><jats:title>Objective</jats:title><jats:p> We aimed to stratify the risk of vascular event recurrence in patients with cerebral infarction according to living and socioeconomic characteristics and geographic region. </jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p> The Outcomes in Patients with TIA and Cerebrovascular Disease (OPTIC) study is an international prospective study of patients aged 45 years or older who required secondary prevention of stroke [following either an acute transient ischemic attack, minor ischemic strokes, or recent (less than six-months previous), stable, first-ever, nondisabling ischemic stroke]. A total 3635 patients from 245 centers in 17 countries in four regions (Latin America, Middle East, North Africa, South Africa) were enrolled between 2007 and 2008. The outcome measure was the two-year rate of a composite of major vascular events (vascular death, myocardial infarction and stroke). </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> During the two-year follow-up period, 516 patients experienced at least one major cardiovascular event, resulting in an event rate of 15·6% (95% confidence interval 14·4–16·9%). Event rates varied across geographical region ( P &lt; 0·001), ranging from 13·0% in Latin America to 20·7% in North Africa. Unemployment status, living in a rural area, not living in fully serviced accommodation (i.e., house or apartment with its own electricity, toilet and water supply), no health insurance coverage, and low educational level (less than two-years of schooling) were predictors of major vascular events. Major vascular event rates steeply increased with the number of low-quality living/socioeconomic conditions (from 13·4% to 47·9%, adjusted P value for trend &lt;0·001). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Vascular risk in stroke patients in low- and middle-income countries varies not only with the number of arterial beds involved but also with socioeconomic variables. </jats:p></jats:sec>
    Scopus© Citations 11  1