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Characterisation of recent trends in cardiovascular risk factors in young and middle-aged patients with ischaemic stroke and/or transient ischaemic attack
Journal of the Neurological Sciences ( IF 3.6 ) Pub Date : 2020-11-01 , DOI: 10.1016/j.jns.2020.117115 Aditya Bhat 1 , Gary C H Gan 1 , David Makarious 2 , Elizabeth Tan 3 , Henry H L Chen 2 , Nigel Wolfe 4 , Lina Lee 4 , Camelia Burdusel 4 , Maria Carmo P Nunes 5 , Clara K Chow 6 , Timothy C Tan 1
Journal of the Neurological Sciences ( IF 3.6 ) Pub Date : 2020-11-01 , DOI: 10.1016/j.jns.2020.117115 Aditya Bhat 1 , Gary C H Gan 1 , David Makarious 2 , Elizabeth Tan 3 , Henry H L Chen 2 , Nigel Wolfe 4 , Lina Lee 4 , Camelia Burdusel 4 , Maria Carmo P Nunes 5 , Clara K Chow 6 , Timothy C Tan 1
Affiliation
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BACKGROUND
Strokes in the young and middle-aged are associated with a disproportionately large economic and social impact in addition to their clinical effects. Standard Modifiable Cardiovascular Risk Factors (SMuRFs; hypercholesterolaemia, hypertension, diabetes mellitus and smoking) are key drivers of cardiovascular disease including strokes, however recent temporal trends in the younger stroke population have not been well characterised. We aimed to evaluate recent trends of SMuRFs in a cohort of younger patients with ischaemic stroke. METHODS
Consecutive patients aged <65 years with clinical and/or radiological diagnosis of ischaemic stroke or transient ischaemic attack in a tertiary referral centre (2013-2017) were retrospectively appraised. The demographic and clinical comorbidities of these patients were assessed including their SMuRF profile. The prevalence over time and clinical associations of patients with no SMuRFs were studied and compared to patients with SMuRFs. RESULTS
Of 487 patients (53.49 ± 9.13 yrs., 60% men) analysed, 23% did not have SMuRFs. The proportion of "non-SMuRF" patients increased over time (p < 0.01) and this trend was not influenced by age (p = 0.48) or gender (p = 0.68). The presence of SMuRFs was not associated with in-hospital outcomes, however patients without SMuRFs were significantly less likely to be discharged on blood pressure (p < 0.01) and lipid-lowering therapies (p = 0.03). CONCLUSIONS
The proportion of younger stroke patients without SMuRFs is substantial and has increased over time. Our findings highlight the need for further research to better understand the mechanisms underlying stroke development in this population and whether less risk factor treatment in this population could impact longer term outcomes.
中文翻译：
年轻和中年缺血性卒中和/或短暂性脑缺血发作患者心血管危险因素的近期趋势特征
背景技术中青年中风除了其临床影响外，还与不成比例的巨大经济和社会影响有关。标准的可改变心血管危险因素（SMuRF；高胆固醇血症、高血压、糖尿病和吸烟）是包括中风在内的心血管疾病的关键驱动因素，但近期年轻中风人群的时间趋势尚未得到很好的表征。我们旨在评估一组年轻的缺血性卒中患者中 SMuRF 的近期趋势。方法 对在三级转诊中心（2013-2017 年）临床和/或放射学诊断为缺血性卒中或短暂性脑缺血发作的连续 65 岁以下患者进行回顾性评估。评估了这些患者的人口统计学和临床合并症，包括他们的 SMuRF 特征。研究了没有 SMuRF 的患者随时间推移的患病率和临床关联，并与有 SMuRF 的患者进行了比较。结果 在分析的 487 名患者（53.49 ± 9.13 岁，60% 男性）中，23% 没有 SMuRF。“非 SMuRF”患者的比例随着时间的推移而增加 (p < 0.01)，而且这种趋势不受年龄 (p = 0.48) 或性别 (p = 0.68) 的影响。SMuRFs 的存在与住院结果无关，但是没有 SMuRFs 的患者在血压 (p < 0.01) 和降脂治疗 (p = 0.03) 后出院的可能性显着降低。结论 没有 SMuRFs 的年轻卒中患者的比例很大，并且随着时间的推移而增加。
更新日期：2020-11-01
中文翻译：
年轻和中年缺血性卒中和/或短暂性脑缺血发作患者心血管危险因素的近期趋势特征
背景技术中青年中风除了其临床影响外，还与不成比例的巨大经济和社会影响有关。标准的可改变心血管危险因素（SMuRF；高胆固醇血症、高血压、糖尿病和吸烟）是包括中风在内的心血管疾病的关键驱动因素，但近期年轻中风人群的时间趋势尚未得到很好的表征。我们旨在评估一组年轻的缺血性卒中患者中 SMuRF 的近期趋势。方法 对在三级转诊中心（2013-2017 年）临床和/或放射学诊断为缺血性卒中或短暂性脑缺血发作的连续 65 岁以下患者进行回顾性评估。评估了这些患者的人口统计学和临床合并症，包括他们的 SMuRF 特征。研究了没有 SMuRF 的患者随时间推移的患病率和临床关联，并与有 SMuRF 的患者进行了比较。结果 在分析的 487 名患者（53.49 ± 9.13 岁，60% 男性）中，23% 没有 SMuRF。“非 SMuRF”患者的比例随着时间的推移而增加 (p < 0.01)，而且这种趋势不受年龄 (p = 0.48) 或性别 (p = 0.68) 的影响。SMuRFs 的存在与住院结果无关，但是没有 SMuRFs 的患者在血压 (p < 0.01) 和降脂治疗 (p = 0.03) 后出院的可能性显着降低。结论 没有 SMuRFs 的年轻卒中患者的比例很大，并且随着时间的推移而增加。
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