Are lacunar strokes really different? : A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts
Differences in risk factors between lacunar and nonlacunar infarcts might support a distinct arterial pathological process underlying lacunar infarction. We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calcu...
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| Veröffentlicht in: | Stroke (1970) 2005-04, Vol.36 (4), p.891-904 |
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| container_title | Stroke (1970) |
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| creator | JACKSON, Caroline SUDLOW, Cathie LANDAU, William M NASSIEF, Abdullah |
| description | Differences in risk factors between lacunar and nonlacunar infarcts might support a distinct arterial pathological process underlying lacunar infarction.
We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calculated study-specific and pooled relative risks (RRs) for lacunar versus nonlacunar infarction.
A total of 16 of 28 studies included risk factors in their ischemic stroke subtype definitions. Hypertension and diabetes appeared commoner among patients with lacunar versus nonlacunar infarction. However, analyses confined to studies using risk factor-free ischemic subtype definitions found only a marginal excess of hypertension with lacunar versus nonlacunar infarction (RR, 1.11; 95% CI, 1.04 to 1.19) and no difference for diabetes (RR, 0.95; 95% CI, 0.83 to 1.09). Atrial fibrillation and carotid stenosis were associated more with nonlacunar than lacunar infarction but less so when only studies using risk factor-free classifications were considered. Otherwise, there was no evidence of differences in risk factor profiles.
Risk factor-free ischemic stroke subtype classification methods should be used for comparing risk factor profiles between lacunar and nonlacunar subtypes. |
| doi_str_mv | 10.1161/01.STR.0000157949.34986.30 |
| format | Article |
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We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calculated study-specific and pooled relative risks (RRs) for lacunar versus nonlacunar infarction.
A total of 16 of 28 studies included risk factors in their ischemic stroke subtype definitions. Hypertension and diabetes appeared commoner among patients with lacunar versus nonlacunar infarction. However, analyses confined to studies using risk factor-free ischemic subtype definitions found only a marginal excess of hypertension with lacunar versus nonlacunar infarction (RR, 1.11; 95% CI, 1.04 to 1.19) and no difference for diabetes (RR, 0.95; 95% CI, 0.83 to 1.09). Atrial fibrillation and carotid stenosis were associated more with nonlacunar than lacunar infarction but less so when only studies using risk factor-free classifications were considered. Otherwise, there was no evidence of differences in risk factor profiles.
Risk factor-free ischemic stroke subtype classification methods should be used for comparing risk factor profiles between lacunar and nonlacunar subtypes.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000157949.34986.30</identifier><identifier>PMID: 15761206</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Atrial Fibrillation - complications ; Biological and medical sciences ; Blood Pressure ; Brain Infarction - diagnosis ; Brain Infarction - pathology ; Carotid Stenosis - complications ; Diabetes Complications - diagnosis ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Hypertension - complications ; Investigative techniques, diagnostic techniques (general aspects) ; Ischemia ; Male ; Medical sciences ; Middle Aged ; Nervous system ; Nervous system (semeiology, syndromes) ; Neurology ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Risk ; Risk Factors ; Sensitivity and Specificity ; Stroke - diagnosis ; Stroke - pathology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2005-04, Vol.36 (4), p.891-904</ispartof><rights>2005 INIST-CNRS</rights><rights>2005 American Heart Association, Inc. 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c380t-89b5224159b0fc78930082a57a0c120e41a39837b6a723c431a251d8e04786153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16711293$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15761206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>JACKSON, Caroline</creatorcontrib><creatorcontrib>SUDLOW, Cathie</creatorcontrib><creatorcontrib>LANDAU, William M</creatorcontrib><creatorcontrib>NASSIEF, Abdullah</creatorcontrib><title>Are lacunar strokes really different? : A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Differences in risk factors between lacunar and nonlacunar infarcts might support a distinct arterial pathological process underlying lacunar infarction.
We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calculated study-specific and pooled relative risks (RRs) for lacunar versus nonlacunar infarction.
A total of 16 of 28 studies included risk factors in their ischemic stroke subtype definitions. Hypertension and diabetes appeared commoner among patients with lacunar versus nonlacunar infarction. However, analyses confined to studies using risk factor-free ischemic subtype definitions found only a marginal excess of hypertension with lacunar versus nonlacunar infarction (RR, 1.11; 95% CI, 1.04 to 1.19) and no difference for diabetes (RR, 0.95; 95% CI, 0.83 to 1.09). Atrial fibrillation and carotid stenosis were associated more with nonlacunar than lacunar infarction but less so when only studies using risk factor-free classifications were considered. Otherwise, there was no evidence of differences in risk factor profiles.
Risk factor-free ischemic stroke subtype classification methods should be used for comparing risk factor profiles between lacunar and nonlacunar subtypes.</description><subject>Aged</subject><subject>Atrial Fibrillation - complications</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Brain Infarction - diagnosis</subject><subject>Brain Infarction - pathology</subject><subject>Carotid Stenosis - complications</subject><subject>Diabetes Complications - diagnosis</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Stroke - diagnosis</subject><subject>Stroke - pathology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkdtuEzEQhi0EoqHwCshCgrtdfFifekEVVZykSkhQrq1ZxwbTjR3sTau8Ak-NS0MCvrE8_v5_ZvQj9IKSnlJJXxPaf7n63JN2qFBmMD0fjJY9Jw_Qggo2dINk-iFaEMJNxwZjTtCTWn80nnEtHqOTJpOUEblAv5bF4wncNkHBdS752ldcPEzTDq9iCL74NJ_jM7zEdVdnv4Y5ugbcRH-LczgwrsliwiXWaxzAzbngTckhTq0--vnW-3RoA2mFU05_nzEFKG6uT9GjAFP1z_b3Kfr67u3VxYfu8tP7jxfLy85xTeZOm1EwNlBhRhKc0oYTohkIBcS1nfxAgRvN1ShBMe4GToEJutKeDEpLKvgpenPvu9mOa79ybcECk92UuIaysxmi_f8nxe_2W76xTChF9Z3Bq71ByT-3vs52Havz0wTJ5221UgnZUuENPLsHXcm1Fh8OTSixd1FaQm2L0h6jtH-itJw08fN_xzxK99k14OUegOpgCgWSi_XISUUpa1P8BvWIqgc</recordid><startdate>20050401</startdate><enddate>20050401</enddate><creator>JACKSON, Caroline</creator><creator>SUDLOW, Cathie</creator><creator>LANDAU, William M</creator><creator>NASSIEF, Abdullah</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20050401</creationdate><title>Are lacunar strokes really different? : A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts</title><author>JACKSON, Caroline ; SUDLOW, Cathie ; LANDAU, William M ; NASSIEF, Abdullah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-89b5224159b0fc78930082a57a0c120e41a39837b6a723c431a251d8e04786153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - complications</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Brain Infarction - diagnosis</topic><topic>Brain Infarction - pathology</topic><topic>Carotid Stenosis - complications</topic><topic>Diabetes Complications - diagnosis</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Ischemia</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Stroke - diagnosis</topic><topic>Stroke - pathology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>JACKSON, Caroline</creatorcontrib><creatorcontrib>SUDLOW, Cathie</creatorcontrib><creatorcontrib>LANDAU, William M</creatorcontrib><creatorcontrib>NASSIEF, Abdullah</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>JACKSON, Caroline</au><au>SUDLOW, Cathie</au><au>LANDAU, William M</au><au>NASSIEF, Abdullah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are lacunar strokes really different? : A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2005-04-01</date><risdate>2005</risdate><volume>36</volume><issue>4</issue><spage>891</spage><epage>904</epage><pages>891-904</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Differences in risk factors between lacunar and nonlacunar infarcts might support a distinct arterial pathological process underlying lacunar infarction.
We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calculated study-specific and pooled relative risks (RRs) for lacunar versus nonlacunar infarction.
A total of 16 of 28 studies included risk factors in their ischemic stroke subtype definitions. Hypertension and diabetes appeared commoner among patients with lacunar versus nonlacunar infarction. However, analyses confined to studies using risk factor-free ischemic subtype definitions found only a marginal excess of hypertension with lacunar versus nonlacunar infarction (RR, 1.11; 95% CI, 1.04 to 1.19) and no difference for diabetes (RR, 0.95; 95% CI, 0.83 to 1.09). Atrial fibrillation and carotid stenosis were associated more with nonlacunar than lacunar infarction but less so when only studies using risk factor-free classifications were considered. Otherwise, there was no evidence of differences in risk factor profiles.
Risk factor-free ischemic stroke subtype classification methods should be used for comparing risk factor profiles between lacunar and nonlacunar subtypes.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>15761206</pmid><doi>10.1161/01.STR.0000157949.34986.30</doi><tpages>14</tpages></addata></record> |
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| subjects | Aged Atrial Fibrillation - complications Biological and medical sciences Blood Pressure Brain Infarction - diagnosis Brain Infarction - pathology Carotid Stenosis - complications Diabetes Complications - diagnosis Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Hypertension - complications Investigative techniques, diagnostic techniques (general aspects) Ischemia Male Medical sciences Middle Aged Nervous system Nervous system (semeiology, syndromes) Neurology Radiodiagnosis. Nmr imagery. Nmr spectrometry Risk Risk Factors Sensitivity and Specificity Stroke - diagnosis Stroke - pathology Vascular diseases and vascular malformations of the nervous system |
| title | Are lacunar strokes really different? : A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts |
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