Common and specific risk factors for ischemic stroke in elderly: Differences based on type of ischemic stroke and aging

J Neurol Sci. 2017 Sep 15:380:85-91. doi: 10.1016/j.jns.2017.07.001. Epub 2017 Jul 4.

Abstract

Background: The risk factors among the types of ischemic stroke (atherothrombotic cerebral infarction: ATI, cardio-embolic infarction: CEI, lacunar infarction: LI) in aged stroke patients have rarely been compared to each other.

Methods: We compared the clinical parameters of 300 elderly patients with ischemic stroke, age 65-98years, to 100 age-matched control patients.

Results: Comparison by parametric test and logistic regression analysis between all 300 and 100 control patients showed higher systolic and diastolic blood pressures (p<0.001, p=0.03), lower estimated glomerular filtration rate (eGFR) (p=0.01), larger cardiothoracic ratio (CTR) (p<0.001), smoking (p<0.01) and possibly poor adherence to anti-hypertensive agents in the ischemic stroke patients (p<0.001). Comparisons among three types (n=100 for each) showed the highest atheromatous risk factors for ATI to be hemoglobin A1c (p=0.01) and low-density lipoprotein (p<0.001) and for CEI to be largest cardiac load, indicated by largest left atrial dimension (p<0.001), and CTR (p<0.001). Triglyceride level was found to be a borderline risk factor for LI (p=0.054). Comparison between those aged <74 versus ≥75years (n=150 for each) showed a lower eGFR (p=0.02) and larger right atrial dimension (p<0.001) in patients ≥75.

Conclusion: The risk factors were quite different among the subtypes and aging.

Keywords: Elderly patients; Ischemic stroke; Risk factors.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / drug therapy
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / physiopathology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Retrospective Studies
  • Risk Factors
  • Stroke / diagnostic imaging
  • Stroke / drug therapy
  • Stroke / epidemiology*
  • Stroke / physiopathology