Risk factors, management and outcome of subtypes of ischemic stroke: a stroke registry from the Arabian Gulf.
BACKGROUND
Data on the determinants and outcome of ischemic stroke (IS) from the Arabian Gulf countries (AGC) are still scanty. The aim of this study was to characterize IS in six large stroke centers on the Arabian peninsula.


METHODS
IS subtypes were evaluated in four AGC from January 2006 to December 2007 in a large prospective multicenter hospital-based stroke registry including demographics, baseline risk factors, outcome and management.


RESULTS
A total of 780 patients with IS were included. Mean age was 58.9 years (63.7% males). Large-artery atherosclerosis (LAA) (38.1%) was the most common subtype followed by lacunar stroke (LS)(34.7%), cardioembolic stroke (CE)(13.5%) and other determined causes (7%). LAA and CE were both more commonly observed over the age of 70. LAA showed a higher male preponderance, and the highest prevalence of hypertension, diabetes, obesity and ischemic heart disease among all subtypes. Obesity was a risk factor for both LAA and CE. Anterior circulation stroke was significantly more affected in LAA (21.2%), CE (19%) and LS (15.1%) subtype of stroke than in posterior circulation strokes (4.4%, 2.9% and 2.8%, respectively) (p<0.05). Only 0.8% of patients received thrombolysis. The 90-day outcome was worst in LAA and least affected in LS. The over-all 90-day mortality was 2.1%.


CONCLUSIONS
Demographically, our data are different from those in Western registries but the distribution of stroke subtypes is comparable. Compared to Asian registries the ratio LS versus LAA was much lower. For the first time these data allow to study the IS profile in this population.
Deleu
Dirk
D
Department of Neurology (Medicine), Hamad Medical Corporation, Doha, Qatar. ddeleu@hmc.org.qa
Inshasi
Jihad
J
Akhtar
Naveed
N
Ali
Jafer
J
Vurgese
Thomas
T
Ali
Shujauldin
S
Rajan
Manorama
M
AlMutairy
Moudi
M
Zayed
Ahmed
A
Paulose
George
G
Nouri
Kassid
K
Thussu
Anil
A
Miyares
Francisco Ruiz
FR
Abdeen
Tayseer
T
AlHail
Hassan
H
Alshubaili
Asmahan
A
Mahmoud
Hisham
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D018912:Arabs / Q000706:statistics & numerical data*; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy