on March 10, 2005
Published online before print March 10, 2005, doi: 10.1161/01.STR.0000157949.34986.30
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on August 6, 2004
From the Division of Clinical Neurosciences, University of Edinburgh, United Kingdom. * To whom correspondence should be addressed. E-mail: cathie.sudlow{at}ed.ac.uk.
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.
Accepted on August 31, 2004
Are Lacunar Strokes Really Different? A Systematic Review of Differences in Risk Factor Profiles Between Lacunar and Nonlacunar Infarcts
Caroline Jackson BSc and Cathie Sudlow DPhil, MRCP*
Key words: stroke • risk factors • meta-analysis • lacunar infarction
Related Article:
Stroke 2005 36: 902-904.
This article has been cited by other articles:
 |
|
 |
|
  W. M. Landau What Is a Lacune? Dogged deja vu doggerel Stroke, July 1, 2009; 40(7): e498 - e499. [Full Text] [PDF]
|
|
|
|
|
|
E. L. Bailey, J. McCulloch, C. Sudlow, and J. M. Wardlaw Potential Animal Models of Lacunar Stroke: A Systematic Review Stroke, June 1, 2009; 40(6): e451 - e458. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. N. Doubal, B. Dhillon, M. S. Dennis, and J. M. Wardlaw Retinopathy in Ischemic Stroke Subtypes Stroke, February 1, 2009; 40(2): 389 - 393. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y Bejot, M Caillier, D Ben Salem, G Couvreur, O Rouaud, G-V Osseby, J Durier, C Marie, T Moreau, and M Giroud Ischaemic stroke subtypes and associated risk factors: a French population based study J. Neurol. Neurosurg. Psychiatry, December 1, 2008; 79(12): 1344 - 1348. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B Norrving Lacunar infarcts: no black holes in the brain are benign Practical Neurology, August 1, 2008; 8(4): 222 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Bejot, A. Catteau, M. Caillier, O. Rouaud, J. Durier, C. Marie, A. Di Carlo, G.-V. Osseby, T. Moreau, and M. Giroud Trends in Incidence, Risk Factors, and Survival in Symptomatic Lacunar Stroke in Dijon, France, From 1989 to 2006: A Population-Based Study Stroke, July 1, 2008; 39(7): 1945 - 1951. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K Park, N Yasuda, S Toyonaga, E Tsubosaki, H Nakabayashi, and K Shimizu Significant associations of metabolic syndrome and its components with silent lacunar infarction in middle aged subjects J. Neurol. Neurosurg. Psychiatry, June 1, 2008; 79(6): 719 - 721. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Khan, L. Porteous, A. Hassan, and H. S Markus Risk factor profile of cerebral small vessel disease and its subtypes J. Neurol. Neurosurg. Psychiatry, July 1, 2007; 78(7): 702 - 706. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Viehman, J. L. Saver, D. S. Liebeskind, S. Starkman, L. K. Ali, B. Buck, T. Razinia, and B. Ovbiagele Utility of Urinalysis in Discriminating Cardioembolic Stroke Mechanism Arch Neurol, May 1, 2007; 64(5): 667 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. O. Pruissen, S. A.M. Gerritsen, T. J. Prinsen, J. M. Dijk, L. J. Kappelle, A. Algra, and on behalf of the SMART Study Group Carotid Intima-Media Thickness Is Different in Large- and Small-Vessel Ischemic Stroke: The SMART Study Stroke, April 1, 2007; 38(4): 1371 - 1373. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Liem, J. van der Grond, J. Haan, R. van den Boom, M. D. Ferrari, Y. M. Knaap, M. H. Breuning, M. A. van Buchem, H. A.M. Middelkoop, and S. A.J. Lesnik Oberstein Lacunar Infarcts Are the Main Correlate With Cognitive Dysfunction in CADASIL Stroke, March 1, 2007; 38(3): 923 - 928. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Labovitz, B. Boden-Albala, W. A. Hauser, and R. L. Sacco Lacunar infarct or deep intracerebral hemorrhage: Who gets which? The Northern Manhattan Study Neurology, February 20, 2007; 68(8): 606 - 608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ohira, E. Shahar, L. E. Chambless, W. D. Rosamond, T. H. Mosley Jr, and A. R. Folsom Risk Factors for Ischemic Stroke Subtypes: The Atherosclerosis Risk in Communities Study Stroke, October 1, 2006; 37(10): 2493 - 2498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Wardlaw, S. C. Lewis, S. L. Keir, M. S. Dennis, and S. Shenkin Cerebral Microbleeds Are Associated With Lacunar Stroke Defined Clinically and Radiologically, Independently of White Matter Lesions Stroke, October 1, 2006; 37(10): 2633 - 2636. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Dijk, Y. van der Graaf, M. L. Bots, D. E. Grobbee, A. Algra, and on behalf of the SMART study group Carotid intima-media thickness and the risk of new vascular events in patients with manifest atherosclerotic disease: the SMART study Eur. Heart J., August 2, 2006; 27(16): 1971 - 1978. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J. Hankey Potential New Risk Factors for Ischemic Stroke: What Is Their Potential? Stroke, August 1, 2006; 37(8): 2181 - 2188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. H.A. Halkes, L. J. Kappelle, J. van Gijn, I. van Wijk, P. J. Koudstaal, and A. Algra Large Subcortical Infarcts: Clinical Features, Risk Factors, and Long-Term Prognosis Compared With Cortical and Small Deep Infarcts Stroke, July 1, 2006; 37(7): 1828 - 1832. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E L L M De Schryver, A Algra, R C J M Donders, J van Gijn, and L J Kappelle Type of stroke after transient monocular blindness or retinal infarction of presumed arterial origin J. Neurol. Neurosurg. Psychiatry, June 1, 2006; 77(6): 734 - 738. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sacco, C. Marini, R. Totaro, T. Russo, D. Cerone, and A. Carolei A population-based study of the incidence and prognosis of lacunar stroke Neurology, May 9, 2006; 66(9): 1335 - 1338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-J. Ariesen, A. Algra, and L. J. Kappelle Antiplatelet Drugs In the Secondary Prevention After Stroke: Differential Efficacy in Large Versus Small Vessel Disease? A Subgroup Analysis From ESPS-2 Stroke, January 1, 2006; 37(1): 134 - 138. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Jackson and C. Sudlow Comparing risks of death and recurrent vascular events between lacunar and non-lacunar infarction Brain, November 1, 2005; 128(11): 2507 - 2517. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T.-H. Lee and K.-C. Chang Editorial Comment--Are We in Another Unavoidable 'Diagnose and Adios' Era? Stroke, September 1, 2005; 36(9): 1852 - 1853. [Full Text] [PDF]
|
|
|
|
|
|
W. M. Landau and A. Nassief Editorial Comment-- Time to Burn the TOAST Stroke, April 1, 2005; 36(4): 902 - 904. [Full Text] [PDF]
|
|