Risk factors for first-ever acute ischemic non-embolic stroke in elderly individuals.
BACKGROUND
Stroke is a leading cause of mortality and subsequent serious long-term physical and mental disability among survivors. In the elderly, ischemic stroke accounts for more than 80% of all strokes.


OBJECTIVE
To identify major risk factors for a first-ever acute ischemic/non-embolic stroke in individuals older than 70 years.


METHODS
A population-based case-control study of patients admitted to the University Hospital of Ioannina, Epirus, Greece, due to first-ever ischemic/non-embolic stroke from March 1997 to January 2002. All patients were subjected to brain CT and had their serum lipids and biochemical metabolic parameters determined within 24 h from the onset of symptoms.


RESULTS
A total of 163 (aged>70 years) consecutive stroke patients and 166 apparently healthy volunteers were studied. An atherogenic lipid profile and metabolic disturbances were more prevalent in the patient group than in stroke-free controls. Multivariate logistic regression analysis identified diabetes mellitus (odds ratio (OR), 1.92; 95% CI, 1.02-3.63), triglycerides (TG) (OR, 1.16; 95% CI, 1.09-1.22), HDL-cholesterol (OR, 0.57; 95% CI, 0.43-0.76), apo A-I (OR, 0.80; 95% CI, 0.70-0.92), lipoprotein(a) [LP(a)] (OR, 1.51; 95% CI, 1.25-1.79), uric acid (OR, 1.30; 95% CI, 1.06-1.59) albumin (OR, 0.38; 95% CI, 0.20-0.70) fibrinogen (OR, 1.10; 95% CI, 1.05-1.13) and the metabolic syndrome (OR 2.48, 95% CI, 1.16-5.29) as significantly associated with ischemic/non-embolic stroke.


CONCLUSIONS
Ischemic non-embolic stroke in the elderly is associated with dyslipidemia and several predictor metabolic factors, which could be substantially modified by lifestyle changes and therapeutic intervention.
Milionis
Haralampos J
HJ
Department of Internal Medicine, Medical School, University of Ioannina, 451 10 Ioannina, Greece.
Liberopoulos
Evangelos
E
Goudevenos
John
J
Bairaktari
Eleni T
ET
Seferiadis
Konstantinos
K
Elisaf
Moses S
MS
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006115:Greece / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000097:blood; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid; D005340:Fibrinogen; D002784:Cholesterol