LONG-TERM TRENDS IN INCIDENCE AND RISK FACTORS OF ISCHAEMIC STROKE TOAST SUBTYPES: THE SOUTH LONDON STROKE REGISTER (SLSR)

TY - JOUR

T1 - LONG-TERM TRENDS IN INCIDENCE AND RISK FACTORS OF ISCHAEMIC STROKE TOAST SUBTYPES

T2 - European Stroke Organisation Conference 2018, Gothenburg, May 2018

AU - Wafa, Hatem Abdelaziz Mohamed

AU - Rudd, Anthony

AU - Wolfe, Charles David Alexander

AU - Wang, Yanzhong

PY - 2018/5/16

Y1 - 2018/5/16

N2 - Background and Aims: To estimate long-term trends in incidence, riskfactors, and preventive treatments for ischaemic stroke aetiological subtypes.Method: Data from the South London Stroke Register (SLSR) between2000 and 2015 were studied. Ischaemic strokes (IS) were classified basedon Trial of Org 10172 in Acute Stroke Treatment (TOAST) into largeartery atherosclerosis (LAA), cardio-embolism (CE), small vessel occlusion(SVO), or other causes. After calculation of the annual and quadrennialage-, sex-, and ethnicity-specific incidence rates by subtype for the16-year period, we analysed the trends using Cochran-Armitage tests, Poisson regression models, and locally estimated scatterplot smoothers(loess). Multiple logistic regressions were performed to further investigatethe changes in pre-stroke risk factors.Results: A total of 3088 patients with IS were registered. Between 2000-03 and 2012-15, IS incidence decreased by 43% from 1373 to 78 4/100,000/year (relative incidence 057, 95% CI 05-064). Significantdeclines were observed in all subtypes, particularly in SVO (374–18;p<00001) and less in CE (393–25; p<00001). Reductions were significantin males, females, and white people, but not in black groups(1446–1162; p¼031). Despite the increasing prevalence of hypertensionand atrial fibrillation, preventive use of antihypertensive and antiplateletdrugs was declining. On the other hand, a fourfold increase in prioruse of cholesterol-lowering agents was found (adjusted odds ratio 396,95% CI 298-529).Conclusion: Incidence rates have declined over time among ischaemicstroke subtypes, but not in black groups. Life style changes and theincreasing use of cholesterol-lowering agents may have contributed tothe observed trends.

AB - Background and Aims: To estimate long-term trends in incidence, riskfactors, and preventive treatments for ischaemic stroke aetiological subtypes.Method: Data from the South London Stroke Register (SLSR) between2000 and 2015 were studied. Ischaemic strokes (IS) were classified basedon Trial of Org 10172 in Acute Stroke Treatment (TOAST) into largeartery atherosclerosis (LAA), cardio-embolism (CE), small vessel occlusion(SVO), or other causes. After calculation of the annual and quadrennialage-, sex-, and ethnicity-specific incidence rates by subtype for the16-year period, we analysed the trends using Cochran-Armitage tests, Poisson regression models, and locally estimated scatterplot smoothers(loess). Multiple logistic regressions were performed to further investigatethe changes in pre-stroke risk factors.Results: A total of 3088 patients with IS were registered. Between 2000-03 and 2012-15, IS incidence decreased by 43% from 1373 to 78 4/100,000/year (relative incidence 057, 95% CI 05-064). Significantdeclines were observed in all subtypes, particularly in SVO (374–18;p<00001) and less in CE (393–25; p<00001). Reductions were significantin males, females, and white people, but not in black groups(1446–1162; p¼031). Despite the increasing prevalence of hypertensionand atrial fibrillation, preventive use of antihypertensive and antiplateletdrugs was declining. On the other hand, a fourfold increase in prioruse of cholesterol-lowering agents was found (adjusted odds ratio 396,95% CI 298-529).Conclusion: Incidence rates have declined over time among ischaemicstroke subtypes, but not in black groups. Life style changes and theincreasing use of cholesterol-lowering agents may have contributed tothe observed trends.

U2 - 10.1177/2396987318770127

DO - 10.1177/2396987318770127

M3 - Meeting abstract

SN - 2396-9873

VL - 3

SP - 26

EP - 26

JO - European Stroke Journal

JF - European Stroke Journal

IS - 1_suppl

M1 - AS15-009

Y2 - 16 May 2018 through 18 May 2018

ER -