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Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis

BACKGROUND: Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region. METHODS: The study is an analytical prospective cross-sectional study of 200 adults fr...

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Autores principales: Kamal, Ayeesha Kamran, Majeed, Farzin, Pasha, Omrana, Rehman, Hasan, Islam, Muhammad, Azam, Iqbal, Ilyas, Muhammad Saleem, Hussain, Munawar, Masood, Kamran, Ahmed, Bilal, Nazir, Sumaira, Sajjad, Zafar, Kasner, Scott E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236665/
https://www.ncbi.nlm.nih.gov/pubmed/25124284
http://dx.doi.org/10.1186/s12883-014-0155-6
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author Kamal, Ayeesha Kamran
Majeed, Farzin
Pasha, Omrana
Rehman, Hasan
Islam, Muhammad
Azam, Iqbal
Ilyas, Muhammad Saleem
Hussain, Munawar
Masood, Kamran
Ahmed, Bilal
Nazir, Sumaira
Sajjad, Zafar
Kasner, Scott E
author_facet Kamal, Ayeesha Kamran
Majeed, Farzin
Pasha, Omrana
Rehman, Hasan
Islam, Muhammad
Azam, Iqbal
Ilyas, Muhammad Saleem
Hussain, Munawar
Masood, Kamran
Ahmed, Bilal
Nazir, Sumaira
Sajjad, Zafar
Kasner, Scott E
author_sort Kamal, Ayeesha Kamran
collection PubMed
description BACKGROUND: Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region. METHODS: The study is an analytical prospective cross-sectional study of 200 adults from Radiology Departments of two diagnostic centers in Karachi. Eligible participants confirmed the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS) and underwent an interview covering medical, socio demographic, lifestyle and anthropometric evaluation using locally validated and standardized definitions. Magnetic Resonance Images (MRI) were centrally reviewed to detect ICAD using the criterion used in the Warfarin–Aspirin Symptomatic Intracranial Disease study. The risk factors associated with asymptomatic ICAD are reported along with prevalence ratios. RESULTS: Of the 200 participants, ICAD was found in 34.5% (n = 69) of the participants. Mean age was 37.1 (S.D 15.1) years with 62% younger than 45 years. Self-reported hypertension was found in 26.5% subjects, diabetes in 9%, dyslipidemia in 5% and depression in 60%. Smokeless tobacco (Adjusted PR 3.27 (1.07-6.05)), Western diet, high socioeconomic status (Adjusted PR 2.26 (1.99-5.62)) and dyslipidemia (Adjusted PR 1.88 (1.25-2.21)) had significant associations with ICAD after multivariable analysis. Age, gender, diabetes, hypertension, depression and physical activity did not have a significant association. CONCLUSION: ICAD was found on MRI in one in three asymptomatic Pakistanis and was associated with modifiable risks. Initiatives targeting primary prevention may be able to decrease the burden of disease caused by stroke due to ICAD. STUDY REGISTRATION NUMBER: NCT02072876 2/25/2014
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spelling pubmed-42366652014-11-24 Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis Kamal, Ayeesha Kamran Majeed, Farzin Pasha, Omrana Rehman, Hasan Islam, Muhammad Azam, Iqbal Ilyas, Muhammad Saleem Hussain, Munawar Masood, Kamran Ahmed, Bilal Nazir, Sumaira Sajjad, Zafar Kasner, Scott E BMC Neurol Research Article BACKGROUND: Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region. METHODS: The study is an analytical prospective cross-sectional study of 200 adults from Radiology Departments of two diagnostic centers in Karachi. Eligible participants confirmed the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS) and underwent an interview covering medical, socio demographic, lifestyle and anthropometric evaluation using locally validated and standardized definitions. Magnetic Resonance Images (MRI) were centrally reviewed to detect ICAD using the criterion used in the Warfarin–Aspirin Symptomatic Intracranial Disease study. The risk factors associated with asymptomatic ICAD are reported along with prevalence ratios. RESULTS: Of the 200 participants, ICAD was found in 34.5% (n = 69) of the participants. Mean age was 37.1 (S.D 15.1) years with 62% younger than 45 years. Self-reported hypertension was found in 26.5% subjects, diabetes in 9%, dyslipidemia in 5% and depression in 60%. Smokeless tobacco (Adjusted PR 3.27 (1.07-6.05)), Western diet, high socioeconomic status (Adjusted PR 2.26 (1.99-5.62)) and dyslipidemia (Adjusted PR 1.88 (1.25-2.21)) had significant associations with ICAD after multivariable analysis. Age, gender, diabetes, hypertension, depression and physical activity did not have a significant association. CONCLUSION: ICAD was found on MRI in one in three asymptomatic Pakistanis and was associated with modifiable risks. Initiatives targeting primary prevention may be able to decrease the burden of disease caused by stroke due to ICAD. STUDY REGISTRATION NUMBER: NCT02072876 2/25/2014 BioMed Central 2014-08-15 /pmc/articles/PMC4236665/ /pubmed/25124284 http://dx.doi.org/10.1186/s12883-014-0155-6 Text en Copyright © 2014 Kamal et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kamal, Ayeesha Kamran
Majeed, Farzin
Pasha, Omrana
Rehman, Hasan
Islam, Muhammad
Azam, Iqbal
Ilyas, Muhammad Saleem
Hussain, Munawar
Masood, Kamran
Ahmed, Bilal
Nazir, Sumaira
Sajjad, Zafar
Kasner, Scott E
Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis
title Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis
title_full Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis
title_fullStr Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis
title_full_unstemmed Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis
title_short Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis
title_sort clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free pakistanis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236665/
https://www.ncbi.nlm.nih.gov/pubmed/25124284
http://dx.doi.org/10.1186/s12883-014-0155-6
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