Demographics, Socio-Economic Characteristics, and Risk Factor Prevalence in Patients with Non-Cardioembolic Ischaemic Stroke in Low- and Middle-Income Countries: The OPTIC Registry
Journal
International Journal of Stroke
ISSN
1747-4930
1747-4949
Date Issued
2012
Author(s)
Halim Abboud
Julien Labreuche
Antonio Arauz
Alan Bryer
Pablo G Lavados
Ayrton Massaro
Mario Munoz Collazos
Philippe Gabriel Steg
Bassem I Yamout
Eric Vicaut
Pierre Amarenco
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<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 <4) of <24 h duration, or recent (<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 < 0·001); prevalence of metabolic syndrome was 78% (range, 72–84%, P < 0·001). Abnormal ankle brachial index (<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>
Subjects
developing countries
;
epidemiology
;
prevention
;
risk factors
;
socio-economic factors
;
stroke