(Stroke. 1995;26:373-379.)
© 1995 American Heart Association, Inc.
Articles |
Recent Infection as a Risk Factor for Cerebrovascular Ischemia
From the Departments of Neurology (A.J.G., F.B., S.H., C.S.-W., T.B., W.H.), Microbiology (M.M., M.R., H.S.), and Medicine (W.F.), University of Heidelberg; and the Department of Epidemiology, German Cancer Research Center (H.B.), Heidelberg, Germany.
Correspondence to Armin J. Grau, MD, Neurologische Universitätsklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Background and Purpose Previous infection is discussed as a risk factor for ischemic stroke in children and younger adults. We tested the hypothesis that the role of recent infection in cerebrovascular ischemia is not restricted to younger patients and investigated which infections are mainly relevant in this respect.
Methods We performed a case-control study with 197 patients aged 18 to 80 years with acute cerebrovascular ischemia and 197 randomly selected control subjects matched for sex, age, and area of residence.
Results Infection within 1 week before ictus or examination was
significantly more common among patients (38 of 197) than control
subjects (10 of 197; odds ratio [OR], 4.5; 95% confidence interval
[CI], 2.1 to 9.7). Patients more often had febrile and subfebrile
infections (
37.5°C) than control subjects (29 of 197 versus 5 of
197; OR, 7.0; 95% CI, 2.5 to 20). Respiratory tract infections were
most common in both groups. Bacterial infections dominated among
patients but not among control subjects. Infection increased the risk
for cerebrovascular ischemia in all age groups; this reached
significance for patients aged 51 to 60 and 61 to 70 years. The profile
of vascular risk factors was similar in patients with and patients
without previous infection. Infection remained a significant risk
factor when previous stroke, hypertension, diabetes mellitus, coronary
heart disease, and current smoking were included as covariates in a
logistic model (OR, 4.6; 95% CI, 1.9 to 11.3).
Conclusions Recent infection, primarily of bacterial origin, may be a risk factor for cerebrovascular ischemia in older as well as younger patients.
Key Words: cerebral ischemia • infection • risk factor
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