Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts

Jackson, Caroline and Sudlow, Cathie (2005) Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts. Stroke, 36 4: 891-901. doi:10.1161/01.STR.0000157949.34986.30


Author Jackson, Caroline
Sudlow, Cathie
Title Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts
Journal name Stroke   Check publisher's open access policy
ISSN 0039-2499
1524-4628
Publication date 2005-04-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1161/01.STR.0000157949.34986.30
Open Access Status Not yet assessed
Volume 36
Issue 4
Start page 891
End page 901
Total pages 11
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Background and Purpose— Differences in risk factors between lacunar and nonlacunar infarcts might support a distinct arterial pathological process underlying lacunar infarction.
Methods— We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calculated study-specific and pooled relative risks (RRs) for lacunar versus nonlacunar infarction.
Results— A total of 16 of 28 studies included risk factors in their ischemic stroke subtype definitions. Hypertension and diabetes appeared commoner among patients with lacunar versus nonlacunar infarction. However, analyses confined to studies using risk factor–free ischemic subtype definitions found only a marginal excess of hypertension with lacunar versus nonlacunar infarction (RR, 1.11; 95% CI, 1.04 to 1.19) and no difference for diabetes (RR, 0.95; 95% CI, 0.83 to 1.09). Atrial fibrillation and carotid stenosis were associated more with nonlacunar than lacunar infarction but less so when only studies using risk factor–free classifications were considered. Otherwise, there was no evidence of differences in risk factor profiles.
Conclusions— Risk factor–free ischemic stroke subtype classification methods should be used for comparing risk factor profiles between lacunar and nonlacunar subtypes.
Keyword Lacunar infarction
Meta-analysis
Risk factors
Stroke
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Public Health Publications
 
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