Specificities of Ischemic Stroke Risk Factors in Arab-Speaking Countries
Journal
Cerebrovascular Diseases
ISSN
1015-9770
1421-9786
Date Issued
2017
Author(s)
Halim Abboud
Leila Sissani
Julien Labreuche
Antonio Arauz
Marie-Germaine Bousser
Alain Bryer
Angel Chamorro
Marc Fisher
Ian Ford
Kim M. Fox
Michael G. Hennerici
Ayrton Massaro
Heinrich P. Mattle
Mario Munoz Collazos
Peter M. Rothwell
Philippe Gabriel Steg
Eric Vicaut
Bassem Yamouth
Pierre Amarenco
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:p><b><i>Background:</i></b> Stroke is largely preventable, and therefore, a better understanding of risk factors is an essential step in reducing the population stroke rate and resulting disease burden in Arab countries. <b><i>Summary:</i></b> We performed 2 separate analyses in 2 similar populations of patients with noncardioembolic ischemic stroke. This first involved 3,635 patients in the Outcomes in Patients with TIA and Cerebrovascular disease (OPTIC) registry (followed for 2 years), with baseline collection of the usual risk factors and 5 socioeconomic variables (unemployment status, residence in rural area, living in fully serviced accommodation, no health-insurance coverage, and low educational level). The second involved patients in the PERFORM trial (<i>n</i> = 19,100 followed up for 2 years), with baseline collection of the usual risk factors and 1 socioeconomic variable (low educational level). The primary outcome was a composite of nonfatal stroke, nonfatal myocardial infarction, or cardiovascular death. Stroke risk factors were more prevalent in patients in Arab countries. The incidence of major cardiovascular events (MACE; age- and gender-adjusted) was higher in Arab countries (OPTIC, 18.5 vs. 13.3%; PERFORM, 18.4 vs. 9.7%; both <i>p </i>≤ 0.0001). These results remained significant after adjustment on risk factors and were attenuated in OPTIC after further adjustment on socioeconomic variables (hazard ratio 1.24; 95% CI 0.98-1.55; <i>p </i>= 0.07). <b><i>Key Messages:</i></b> Patients with ischemic stroke living in Arab countries had a lower mean socioeconomic status, a much higher prevalence of diabetes mellitus, and a higher rate of MACE compared with patients from non-Arab countries. This finding is partly explained by a higher prevalence of risk factors and also by a high prevalence of poverty and low educational level.</jats:p>
Subjects
stroke
;
tia
;
risk factors
;
socio-economic status