Risk factors for first-ever acute ischemic non-embolic stroke in elderly individuals

Background: Stroke is a leading cause of mortality and subsequent serious long-term physical and mental disability among survivors. In the elderly, ischemic stroke accounts for more than 80% of all strokes. Objectives: To identify major risk factors for a first-ever acute ischemic/non-embolic stroke in individuals older than 70 years. Methods: A population-based case-control study of patients admitted to the University Hospital of Ioannina, Epirus, Greece, due to first-ever ischemic/non-embolic stroke from March 1997 to January 2002. All patients were subjected to brain CT and had their serum lipids and biochemical metabolic parameters determined within 24 h from the onset of symptoms. Results: A total of 163 (aged > 70 years) consecutive stroke patients and 166 apparently healthy volunteers were studied. An atherogenic lipid profile and metabolic disturbances were more prevalent in the patient group than in stroke-free controls. Multivariate logistic regression analysis identified diabetes mellitus (odds ratio (OR), 1.92; 95% Cl, 1.02-3.63), triglycerides (TG) (OR, 1.16; 95% Cl, 1.09-1.22), HDL-cholesterol (OR, 0.57; 95% Cl, 0.43-0.76), apo A-I (OR, 0.80; 95% Cl, 0.70-0.92), lipoprotein(a) [LP(a)] (OR, 1.51; 95% Cl, 1.25-1.79), uric acid (OR, 1.30; 95% CI, 1.06-1.59) albumin (OR, 0.38; 95% Cl, 0.20-0.70) fibrinogen (OR, 1.10; 95% Cl, 1.05 1.13) and the metabolic syndrome (OR 2.48, 95% Cl, 1.16-5.29) as significantly associated with ischemic/non-embolic stroke. Conclusion: Ischemic non-embolic stroke in the elderly is associated with dyslipidemia and several predictor metabolic factors, which could be substantially modified by lifestyle changes and therapeutic intervention. (c) 2004 Elsevier Ireland Ltd. All rights reserved.