Factors that pre-determine the main subtypes of ischemic stroke in middle-aged and senior women

Abstract

Introduction. Brain health and active longevity are affected by a number of stroke risk factors. We should identify their relative impact on the main subtypes of ischemic stroke (IS) in middle-aged and senior women to consider prevention and management strategies. Objective. To assess prevalence of isolated and combined factors that may contribute with a high probability to development of the various IS subtypes in women aged 4574 years. Materials and methods. The study included 348 female patients aged 4574 years including 145 inpatients with carotid IS (main group) from Neurology Department 2, the Research Center of Neurology, and 203 women with cognitive disorders due to the chronic cerebral ischemia (controls). To assess the impact of various risk factors on the main IS subtypes, we generated multivariate predictive models using logistic regression and the Wald test. Results. Predictive modeling of atherothrombotic IS demonstrated that type 2 diabetes mellitus increases IS risk by over 5 times (odds ratio [OR] = 5.961; 95% confidence interval [CI] 1.10232.257; р = 0.038); internal carotid artery stenosis, by 7 times (OR = 7.187; 95% CI 1.82728.273; р = 0.005); history of transient ischemic attacks (TIA), by 61 times (OR = 61.442; 95% CI 7.673491.998; р 0.001); excessive alcohol intake, by 49 times (OR = 49,382; 95% CI 4.557535.121; р = 0.001); and HTN severity, by 4 times (OR = 4.445; 95% CI 2.3318.476; р 0.001). Predictive modeling of cardioembolic IS demonstrated that post-infarction cardiosclerosis increases IS risk by over 118 times (OR = 118.025; 95% CI 5.2102673.796; р = 0.003), atrial fibrillation, by 108 times (OR = 108.493; 95% CI 24.312484.159; р 0.001), history of TIA, by over 71 times (OR = 71.558; 95% CI 7.945644.535; р 0.001); and HTN severity, by over 3 times (OR = 3.957; 95% CI 2.0697.566; р 0.001). Predictive modeling of lacunar IS demonstrated that type 2 diabetes mellitus increases IS risk by 8 times (OR = 8.324; 95% CI 1.92336.041; р = 0.005), history of IS, by over 8 times (OR = 8.99; 95% CI 1.77245.598; р = 0.008); and HTN severity, by 7 times (OR = 7.139; 95% CI 3.49114.599; р 0.001). Conclusion. We identified a number of risk factors that may contribute to the development of the main IS subtypes in middle-aged and senior women.

Keywords

• ischemic stroke
• risk stroke
• predictive modeling
• predictive models