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Socioeconomic development and stroke mortality in the world. / 社會經濟發展與腦卒中死亡率 / CUHK electronic theses & dissertations collection / She hui jing ji fa zhan yu nao zu zhong si wang luJanuary 2008 (has links)
In conclusion, SED is a predictor of stroke mortality. Both childhood and adulthood SED were related to the risk of stroke. Stroke mortality increased with improving SED at a lower stage of development, while it decreased with SED improvement at a higher stage of development. The analysis was conducted among middle- or high-income countries/regions as data only available there. Investigation for low-income countries is warranted as data become available. / Keywords. Socioeconomic development; stroke; mortality / Socioeconomic development (SED) relates to the prevalence of risk factors of stroke and influence health policy. We aim to explore the association of (SED) in childhood and adulthood with stroke mortality among countries/regions, and to examine its impact on time trend of stroke mortality. / The ecological study used data on stroke mortality in five-year age group among countries/regions with death registry covering > 70% population provided by the World Health Organization. SED was measured by Human Development Index (HDI), a composite indicator with longevity, education and standard of living, obtained from the United Nations. Mortality rates (1950-2003) were averaged over three years and in logarithmical scale. HDI from 1960 to 2003 were available for this analysis. The effect of HDI on stroke mortality was analyzed and the major confounders, such as prevalence of hypertension, smoking, diabetes, obesity, and the level of dietary fat and alcohol consumption were adjusted for using regression model. / The results revealed that stroke mortality was inversely associated with HDI in childhood and adulthood respectively. Childhood HDI explained 36% of variance of stroke mortality among countries/regions in men and 35% in women; while adulthood HDI interpreted 34% in men and 52% in women (P < 0.01); annual change of stroke mortality was inversely associated with that of HDI. The peak of stroke mortality was exhibited at HDI = 0.79-0.83 for men and 0.80-0.83 for women. Stroke mortality increased with HDI where HDI < 0.79 for men and 0.80 for women, while it decreased with HDI improvement where HDI > 0.83 for men and women. Controlling for confounders did not materially change the results. / Wu, Shenghui. / Adviser: Xin-Hua Zhang. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3468. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 189-218). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.
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Atrial fibrillation : on its trigger mechanisms, risks and consequenses /Poçi, Dritan, January 2010 (has links)
Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2010. / Härtill 5 uppsatser.
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Relationships Between D-Dimer Levels and Stroke Risk as Well as Adverse Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-AnalysisYuan, Bing, Yang, Tong, Yan, Tao, Cheng, Wenke, Bu, Xiancong 27 March 2023 (has links)
Objective: Abnormal elevation of D-dimer levels is an important indicator of
disseminated intravascular clotting. Therefore, we hypothesized that high D-dimer levels
were associated with the risk of stroke and adverse clinical outcomes of patients with
acute ischemic stroke (AIS) or transient ischemic attack (TIA).
Methods: The present meta-analysis aimed to systematically analyze the associations
between D-dimer and the risk of stroke as well as the clinical outcomes of patients with
post-stroke or TIA. Meanwhile, dose–response analyses were conducted when there
were sufficient data available. Three electronic databases including Pubmed, the Embase
database, and the Cochrane Library were searched by two investigators independently.
All the pooled results were expressed as risk ratios (RRs).
Results: Finally, 22 prospective cohort studies were included into this meta-analysis.
The results suggested that high D-dimer levels were associated with increased risks of
total stroke (RR 1.4, 95%CI 1.20–1.63), hemorrhagic stroke (RR 1.25, 95%CI 0.69–2.25),
and ischemic Stroke (RR 1.55, 95%CI 1.22–1.98), and the dose-dependent relationship
was not found upon dose–response analyses. Besides, the high D-dimer levels on
admission were correlated with increased risks of all-cause mortality [RR 1.77, 95%
confidence interval (CI) 1.26–2.49], 5-day recurrence (RR 2.28, 95%CI 1.32–3.95), and
poor functional outcomes (RR 2.01, 95%CI 1.71–2.36) in patients with AIS or TIA.
Conclusions: On the whole, high D-dimer levels may be associated with the risks of total
stroke and ischemic stroke, but not with hemorrhagic stroke. However, dose–response
analyses do not reveal distinct evidence for a dose-dependent association of D-dimer
levels with the risk of stroke. Besides, high D-dimer levels on admission may predict
adverse clinical outcomes, including all-cause mortality, 5-day recurrence, and 90-day
poor functional outcomes, of patients with AIS or TIA. More studies are warranted to
quantify the effect of D-dimer levels on the risk of stroke or TIA, so as to verify and
substantiate this conclusion in the future.
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Peripheral Arterial Disease as an Independent Predictor for Excess Stroke Morbidity and Mortality in Primary-Care Patients: 5-Year Results of the getABI StudyMeves, Saskia H., Diehm, Curt, Berger, Klaus, Pittrow, David, Trampisch, Hans-Joachim, Burghaus, Ina, Tepohl, Gerhart, Allenberg, Jens-Rainer, Endres, Heinz G., Schwertfeger, Markus, Darius, Harald, Haberl, Roman L. 26 February 2014 (has links) (PDF)
Background:There is controversial evidence with regard to the significance of peripheral arterial disease (PAD) as an indicator for future stroke risk. We aimed to quantify the risk increase for mortality and morbidity associated with PAD. Methods:In an open, prospective, noninterventional cohort study in the primary care setting, a total of 6,880 unselected patients ≧65 years were categorized according to the presence or absence of PAD and followed up for vascular events or deaths over 5 years. PAD was defined as ankle-brachial index (ABI) <0.9 or history of previous peripheral revascularization and/or limb amputation and/or intermittent claudication. Associations between known cardiovascular risk factors including PAD and cerebrovascular mortality/events were analyzed in a multivariate Cox regression model. Results:During the 5-year follow-up [29,915 patient-years (PY)], 183 patients had a stroke (incidence per 1,000 PY: 6.1 cases). In patients with PAD (n = 1,429) compared to those without PAD (n = 5,392), the incidence of all stroke types standardized per 1,000 PY, with the exception of hemorrhagic stroke, was about doubled (for fatal stroke tripled). The corresponding adjusted hazard ratios were 1.6 (95% confidence interval, CI, 1.1–2.2) for total stroke, 1.7 (95% CI 1.2–2.5) for ischemic stroke, 0.7 (95% CI 0.2–2.2) for hemorrhagic stroke, 2.5 (95% CI 1.2–5.2) for fatal stroke and 1.4 (95% CI 0.9–2.1) for nonfatal stroke. Lower ABI categories were associated with higher stroke rates. Besides high age, previous stroke and diabetes mellitus, PAD was a significant independent predictor for ischemic stroke. Conclusions:The risk of stroke is substantially increased in PAD patients, and PAD is a strong independent predictor for stroke. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Risk Factors for Stroke in Adult Men : A Population-based StudyWiberg, Bernice January 2010 (has links)
In the last decades our knowledge concerning cardiovascular risk factors has grown rapidly through results from longitudinal studies. However, despite new treatment, in Western countries coronary heart disease remains the leading cause of death and stroke is still the leading cause of severe disability. The studies reported in these papers examine the relationships between stroke/transient ischaemic attack (TIA) and a number of different factors measured on two different occasions in men born in Uppsala 1920-1924 and are epidemiological in their character. The findings indicate that in addition to already established risk factors, indices of an unhealthy dietary fat intake and high serum lipoprotein(a) are independent predictors of stroke/TIA. Among different glucometabolic variables a low insulin sensitivity index derived from the euglycaemic insulin clamp and proinsulin carries a high predictive value for later stroke, independently of diabetes. Moreover, cognitive test performance measured with Trail Making Test B at age 70 is a strong and independent predictor of brain infarction, indicating that the risk is already increased in the subclinical phase of milder cognitive dysfunction. Performance at a pre-stroke Trail Making Test is also of predictive value for mortality after first-ever stroke/TIA, but none of the studied pre-stroke variables or cognitive tests was found to be related to dependency after an event. In summary these studies provide further knowledge about predictors of stroke and of mortality after first-ever stroke. They also indicate the possible importance of new markers of risk, such as the level of lipoprotein(a), profile of fatty acids in the diet, low insulin sensitivity derived from clamp investigations, level of proinsulin, and cognitive performance measured with Trail Making Tests.
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Peripheral Arterial Disease as an Independent Predictor for Excess Stroke Morbidity and Mortality in Primary-Care Patients: 5-Year Results of the getABI StudyMeves, Saskia H., Diehm, Curt, Berger, Klaus, Pittrow, David, Trampisch, Hans-Joachim, Burghaus, Ina, Tepohl, Gerhart, Allenberg, Jens-Rainer, Endres, Heinz G., Schwertfeger, Markus, Darius, Harald, Haberl, Roman L. January 2010 (has links)
Background:There is controversial evidence with regard to the significance of peripheral arterial disease (PAD) as an indicator for future stroke risk. We aimed to quantify the risk increase for mortality and morbidity associated with PAD. Methods:In an open, prospective, noninterventional cohort study in the primary care setting, a total of 6,880 unselected patients ≧65 years were categorized according to the presence or absence of PAD and followed up for vascular events or deaths over 5 years. PAD was defined as ankle-brachial index (ABI) <0.9 or history of previous peripheral revascularization and/or limb amputation and/or intermittent claudication. Associations between known cardiovascular risk factors including PAD and cerebrovascular mortality/events were analyzed in a multivariate Cox regression model. Results:During the 5-year follow-up [29,915 patient-years (PY)], 183 patients had a stroke (incidence per 1,000 PY: 6.1 cases). In patients with PAD (n = 1,429) compared to those without PAD (n = 5,392), the incidence of all stroke types standardized per 1,000 PY, with the exception of hemorrhagic stroke, was about doubled (for fatal stroke tripled). The corresponding adjusted hazard ratios were 1.6 (95% confidence interval, CI, 1.1–2.2) for total stroke, 1.7 (95% CI 1.2–2.5) for ischemic stroke, 0.7 (95% CI 0.2–2.2) for hemorrhagic stroke, 2.5 (95% CI 1.2–5.2) for fatal stroke and 1.4 (95% CI 0.9–2.1) for nonfatal stroke. Lower ABI categories were associated with higher stroke rates. Besides high age, previous stroke and diabetes mellitus, PAD was a significant independent predictor for ischemic stroke. Conclusions:The risk of stroke is substantially increased in PAD patients, and PAD is a strong independent predictor for stroke. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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