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(Stroke. 2008;39:e1.)
© 2008 American Heart Association, Inc.

Letters to the Editor

Prevalence of Intracranial Atherosclerosis and Coexistent Conditions in Ethnic South Asians

Kazim Sheikh, MD

US Department of Health and Human Services, Centers for Medicare & Medicaid Services, Kansas City, Mo, US

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

Although the objectives of their study were not stated, De Silva et al¹ used clinical data on 200 acute ischemic stroke patients admitted in a hospital in Singapore to determine the prevalence of intracranial large-artery disease (ICLAD) and its risk factors. The study subjects were selected on the basis of their origin of the Indian subcontinent (ethnic South Asians). The authors declared that "ICLAD is the most common vascular lesion in stroke worldwide". To justify their declaration, they cited a reference (Reference 2 in their article¹) to an article published in Int J Stroke. This publication was not found in PubMed Central. The authors found that 54% of stroke patients had ICLAD and they pronounced it as "high burden of ICLAD among ethnic South Asians" without comparing this prevalence with that among non–South Asian stroke patients. Based on the 54% prevalence, the authors concluded that "intracranial large arteries are the predominant site of disease (atherosclerosis)" and that "these data may be extrapolated to ethnic South Asians living in the urban regions of South Asia and developed countries such as the United Kingdom and the United States". Large artery disease in 54% of patients can hardly be described as predominantly intracranial. How can the results based on selected 200 stroke patients in a Singapore hospital be generalized to 1 billion urban South Asians in South Asia and elsewhere?

The descriptive results are confusing. Of the 200 patients, 102 had ICLAD and 86 did not have ICLAD. . . . [Full Text of this Article]

Related Article:

Response to Letter by Sheikh

Deidre A. De Silva, Fung-Peng Woon, Christopher P.L.H Chen, Hui-Meng Chang, and Meng-Cheong Wong
Stroke 2008 39: e2. [Extract] [Full Text] [PDF]