Cohort studies stroke

Ogata J, Yonemura K, Kimura K et al. (2005). Cerebral infarction associated with essential thrombocythemia an autopsy case study. Cerebrovascular Diseases 19 201-205 Olin JW, Shih A (2006). Thromboangiitis obliterans (Buerger s disease). Current Opinions in Rheumatology 18 18-24 Orencia AJ, Petty GW, Khandheria BK et al. (1995a). Risk of stroke with mitral valve prolapse in population-based cohort study. Stroke 26 7-13... 

Abbott AL, Chambers BR, Stork JL et al. (2005). Embolic signals and prediction of ipsilateral stroke or transient ischemic attack in asymptomatic carotid stenosis a multicenter prospective cohort study. Stroke 36 1128-1133 Akins CW (1995). The case for concomitant carotid and coronary artery surgery. British Heart Journal 74 97-98... 

He K, Song Y, Daviglus ML, et al. Fish consumption and incidence of stroke a meta-analysis of cohort studies. Stroke. 2004 35... 

Cui, R., Iso, H., Date, C., Kikuchi, S., and Tamakoshi, A., 2010. Dietary folate and vitamin b6 and B12 intake in relation to mortality from cardiovascular diseases Japan collaborative cohort study. Stroke. 41 1285-1289. 

Almgren T, Persson B, Wilhelmsen L, Rosengren A, An-dersson OK. Stroke and coronary heart disease in treated hypertension - a prospective cohort study over three decades. I Intern Med 2005 257(6) 496-502. 

Elwood, P. C., Pickering, J. E., Hughes, J., Fehily, A. M., and Ness, A. R. (2004b). Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies. Eur. J. Clin. Nutr. 58, 718-724. 

Dauchet, L., Amouyel, R, and Dallongeville, J., Fruit and vegetable consumption and risk of stroke A meta-analysis of cohort studies. Neurology, Oct 25, 65(8), 1193-1197, 2005. 

Gill SS, Rochon PA, Herrmann N, Lee PE, Sykora K, Gunraj N, Normand SLT, Gurwitz JH, Marras C, Wodchis WP, Mamdani M. Atypical antipsychotic drugs and risk of ischaemic stroke population based retrospective cohort study. BMJ 2005 330 445. 

Coronary heart disease is associated with ischemic stroke in postmortem (Stemmermann et al. 1984), twin (Brass et al. 1996), case-control (Feigin et al. 1998) and cohort studies (Harmsen et al. 1990 Shaper et al. 1991 Wolf et al. 1991b Touze et al. 2006) as are electrocardiographic abnormalities, cardiac failure, left ventricular hypertrophy, claudication and asymptomatic peripheral vascular disease (Leys et al. 2006). 

Fig. 14.1. Short-term stroke risk stratified by ABCD score in six cohort studies combined (n=4799 patients). Stroke risks are shown at 2, 7, 30 and 90 days (Johnston et a . 2007).

Patients with major stroke often report earlier short-lived neurological symptoms, and data from population-based studies and trials suggest that approximately 20% of patients with stroke have a preceding TIA (Rothwell and Warlow 2005). A similar proportion of major strokes are probably preceded by a minor stroke. However, the prospective estimation of risk after TIA or minor stroke is challenging, and in the past the risk has been considered to be low (approximately 1-2% at one week and 2-4% at one month) (Hankey et al. 1991 Gubitz et al. 1999 Gubitz and Sandercock 2000 Warlow et al. 2001). However, these risks are now considered underestimates because they were calculated from cohort studies and clinical trials in which patients were recruited some time after their initial event and patients who experienced subsequent stroke before recruitment were excluded (Rothwell 2003). 

In one cohort of 83 consecutive patients with a TIA attending an ED who were scaimed with DWI, abnormalities were identified in 27. The combination of DWI abnormalities and symptoms lasting over an hour was found to be predictive of a combined endpoint of stroke or other vascular event (Purroy et al. 2004). In another cohort of 120 patients with TIA or minor stroke, all of whom received DWI within 24-hours, the presence of abnormalities on DWI was associated with a higher risk of stroke at 90 days, as was vessel occlusion (Coutts et al. 2005). In a further cohort of 87 patients with TIA and 74 with ischemic stroke, the rate of recurrent stroke was highest in the group with TIA and iirfarction on DWI (Ay et al. 2005). Lastly, in a retrospective cohort study of 146 patients with TIA, 37 (25%) had abnormalities on DWI the presence of these abnormalities was shown to be independently associated with a higher risk of in-hospital recurrent TIA or stroke (OR, 11.2 p<0.01) (Prabhakaran et al. 2007). 

In a recent systematic review and meta-analysis of studies of the risk of myocardial infarction and vascular death after TIA and ischemic stroke (Touze et al. 2005), cohort studies including over 100 patients with TIA or ischemic stroke and reporting risks of myocardial infarction or non-stroke vascular death over at least one year of follow-up published between 1980 and 2005 were identified. The analysis included 39 studies reporting outcomes in 65 996 patients. The ranges of annual risks reported in individual studies were 0.4% to 3.8% for non-stroke vascular death, 0.5% to 4.7% for total myocardial infarction, 0.4% to 3.2% for non-fatal myocardial infarction and 0.2% to 3.7% for fatal myocardial infarction. The annual risks obtained through meta-regression were 2.1% (95% Cl, 1.9-2.4) for non-stroke vascular death (29 studies), 2.2% (95% Cl, 1.7-2.7) for total myocardial infarction (22 studies), 0.9% (95% Cl, 0.7-1.2) for non-fatal myocardial infarction (16 studies), and 1.1% (95% Cl, 0.8-1.5) for fatal myocardial infarction (19 studies) (Touze et al. 2005) (Fig. 17.2). 

Kohrmann, M., et al., MRI versus CT-based thrombolysis treatment within and beyond the 3 h time window after stroke onset a cohort study. Lancet Neurol, 2006. 5(8) p. 661-7. 

In addition, five prospective within-population cohort studies have been carried out, four of them on coronary heart disease and one on strokes. The four coronary heart disease studies were carried out in The Netherlands (Zutphen) [139], the USA (Health Professionals study) [140], the U.K. (the Caerphilly study) [141], and Finland [142]. In the Zutphen study, coronary heart disease was inversely associated with flavonol intake, in which a maximum intake of 42 mg/day and a minimum of 12mg/day were recorded. A clear dose-response correlation was observed. In the Health Professionals study, a modest non-significant inverse association was found (flavonoid intake between 40 mg/day and 7 mg/day). The Finnish study indicated a weak inversely associated correlation, while the Caerphilly study involving Welsh men showed that flavonoid intake increased the mortality. 

One of the largest and most recent observational studies of Afib is the ATRIA-1 cohort study at Kaiser Permanente Northern California (KPNC). This cohort comprised 13,559 individuals who were members of KPNC with a diagnosis of Afib during years 1996-2003. These individuals were followed longitudinally for comorbidities, lab values, warfarin treatment, and stroke and death outcomes. The effectiveness of warfarin in reducing the risk of stroke or death was recently addressed in Brooks et al. (2013). The safety analysis in this chapter focuses on the estimation of the causal effect of warfarin on the probability of nonstroke death within the first year of follow-up. 

Engelter, S.T, Bonati, L.H., and Lyrer, P.A. (2006) Intravenous thrombolysis in stroke patients of > or = 80 versus <80 years of age — A systematic review across cohort studies. Age Ageing, 35 572-580. 

Cardiovascular In a matched cohort study 52229 patients who took tegaserod and 52229 patients with similar characteristics who did not were followed for up to 6 months looking for cardiovascular ischemic events (myocardial infarction, acute coronary syndrome, coronary revascularization, and stroke). Tegaserod was not associated with such events [21... 

For stroke, three large-scale prospective cohort studies have investigated the potential protective effect of vitamin Bg intake. Two reported no association between vitamin Bg intake and the incidence of stroke (He et al. 2004 Larsson... 

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