Epidemiological study of incidence and risk factors of Ischemic stroke subtypes according to Trial of ORG 10172 in acute stroke treatment criteria: A 3 years, hospital-based study

Abstract

Background and Purpose: The purpose of this study was to determine the incidence and risk factor of ischemic stroke subtypes by a mechanism-based classifi cation scheme (Trial of ORG 10172 in Acute Stroke Treatment [TOAST]). Materials and Methods: This study was conducted in Indraprastha Apollo Hospital, New Delhi, between 01/01/2004 and 31/12/2006. Out of 361 admitted stroke patients, 244 (67.59%) ischemic stroke patients were analyzed retrospectively for incidence and modifiable risk factors for stroke in our region. The cause of ischemic stroke was classifi ed according to the TOAST criteria. Results: Out of 244 patients 165 (67.6%) were male and 79 (32.4%) were female, the mean age at the time of stroke was 57.1 years, the incidence of different risk factors were as follows: 139 (56.9%, odds ratio 2.71) hypertensive, 85 (34.8%, odds ratio 2.4) diabetics, 95 (38.9%, odds ratio 3.12) smokers, 58 (23.7%, odds ratio 5.34) dyslipidemics, 44 (18.0%, odds ratio 1.43) coronary artery disease (CAD) patients, 14 (5.7%, odds ratio 1.22) patients have the transient ischemic stroke in the past, 13 (5.3%, odds ratio 1.43) were given the history of atrial fibrillation. The incidence rates of ischemic stroke subtypes were as follows: Determined causes; large artery atherosclerosis 141 (57.7%), lacunes 18 (7.7%), cardio-embolism 11 (4.5%), hypercoagulable state 8 (3.2%), un-determined causes; atherosclerosis and/or lacunes 25 (10.2%), embolism and/or two more (hypercoagulable state/CAD) possible causes 7 (2.8%), negative evaluation in 34 (13.9%) patients. Ischemic stroke subtype according to the TOAST criteria was a signifi cant predictor for long-term survival. Conclusions: Our data indicate that large vessel disease is a major cause, and the hypertension, diabetes, smoking, hyperlipidemia are the most common risk factors for Ischemic stroke. [ABSTRACT FROM AUTHOR]