Neurological

Gender-specific risk profiles for acute ischemic stroke

The risk factor profile for acute ischemic stroke (AIS) differed based on gender, according to the results of a cross-sectional population study published in BMC Neurology.

The study researchers retrospectively assessed data collected between 2010 and 2016 at PRISMA Health in the US for risk factors for AIS.

The patients (N = 5469) were split between men (n = 2662) and women (n = 2807). Men with AIS were younger (P <0.001), had a lower BMI (P = 0.002), and had significantly different medical histories, including atrial fibrillation (AF), depression, heart failure, hypertension, and migraines.

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Risk factors for AIS in women included atrial fibrillation (adjusted odds ratio [aOR], 1,308; P = .016), heart failure (aOR, 1.468; P = .005), anti-hypertensive drugs (aOR, 1.549; P = .016), increased total cholesterol (aOR, 1.005; P <.001), increased high - Lipoprotein Cholesterol Density (aOR, 1.037; P <0.001) and National Institutes of Health Elevated Stroke Scale (aOR, 1.022; P <0.001).

In men, the risk factors for AIS were coronary artery disease (aOR, 0.544; P <0.001), history of smoking (aOR, 0.608; P <0.001), elevated serum creatinine (aOR, 0.788; P <0.001), elevated diastolic blood pressure (aOR , 0.979; P = 0.001) and improvement / change in walking ability (aOR, 0.829; P = 0.017).

Stratified by AF status, the unique risk factors for AIS in women with AF were increased low-density lipoprotein cholesterol (aOR, 1.006; P = 0.003) and inability to walk (aOR, 2.258; P = 0.001). In women without atrial fibrillation there were unique factors

BMI (aOR, 0.968; P <0.001), hormone replacement therapy (aOR, 0.016; P = 0.001), increased heart rate (aOR, 0.980; P <0.001) and antihypertensive drugs (aOR, 0.810; P =) .026).

In men with AF, the unique AIS risk characteristics were drug and alcohol abuse (aOR, 0.250; P = 0.016) and sleep apnea (aOR, 0.321; P = 0.012). In men without AF, the associated factors were coronary artery disease (aOR, 1.754; P <0.0001), drug and alcohol use (aOR, 3.560; P <0.0001), international normalization rate (aOR, 1.749; P = 0.003) and increased diastolic blood pressure (aOR, 1.024; P <0.0001).

The area under the Receiver Operating Characteristic Curve (AUC) for the entire cohort was 0.729 (95% CI, 0.7112-0.746; P <0.001). The AUC for patients with AF was 0.757 (95% CI, 0.721-0.793; P <0.001) and without AF was 0.757 (95% CI, 0.740-0.774; P <0.001).

Limitations of this study, including obtaining data from a single center, and that the results may not be applicable to other populations.

Based on their results, the study researchers concluded “that migraines, elevated HDL, and elevated LDL in female AIS patients were associated with atrial fibrillation at baseline, with a history of drug and alcohol abuse, sleep apnea, and higher Serum creatinine levels with male AIS were associated with baseline AF. ”They added that“ More studies are needed to determine whether gender differences in risk factor profiles and goods need to be considered in clinical practice when considering AF as a risk factor management with AIS patients. “

reference

Rathfoot C, Edrissi C, Sanders CB, Knisely K, Poupore N, Nathaniel T. Gender differences in comorbidities and risk factors in ischemic stroke patients with a history of atrial fibrillation. BMC Neurol. 2021; 21: 209. doi: 10.1186 / s12883-021-02214-8

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