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Comparative Study
. 2021 Nov 12;21(1):536.
doi: 10.1186/s12872-021-02344-4.

Comparison of risk factors for ischemic stroke and coronary events in a population-based cohort

Iram Faqir Muhammad  1 , Yan Borné  2 , Suneela Zaigham  2 , Martin Söderholm  2   3 , Linda Johnson  2   3 , Margaretha Persson  2   3 , Olle Melander  2 , Gunnar Engström  2
Affiliations
Comparative Study

Comparison of risk factors for ischemic stroke and coronary events in a population-based cohort

Iram Faqir Muhammad et al. BMC Cardiovasc Disord. .

Abstract

Background: Although coronary events (CE) and ischemic stroke share many risk factors, there are also some important differences. The aim of this paper was to assess the association of risk factors in relation to incident CE and ischemic stroke and to evaluate the heterogeneity in patterns of risk factors between the two outcomes.

Method: Traditional risk factors and inflammatory markers associated with coronary events and ischemic stroke were measured in the Malmö Diet and Cancer Cohort (MDCS, n = 26 519), where a total of 2270 incident ischemic stroke and 3087 incident CE occurred during a mean follow up time 19 ± 6 years, and in relation to inflammatory markers in the cardiovascular sub-cohort (MDC-CV, n = 4795). Cox regression analysis was used to obtain hazard ratios. A modified Lunn-McNeil competing risk analysis was conducted to assess the significance of any differences in risk profiles of these outcomes.

Results: Most cardiovascular risk factors were associated both with incident CE and ischemic stroke. However, current smoking, ApoB, low ApoA1, male sex and education level of ≤ 9 years of schooling were preferentially associated with CE compared to ischemic stroke. Conversely, age showed a stronger association with ischemic stroke than with CE.

Conclusion: CE and ischemic stroke have broadly similar risk factors profiles. However, there are some important differential associations, as well as substantial differences in the magnitude of the association. These could reflect the distinct biology of atherogenesis in different vascular beds. The difference in the determinants highlights the importance of looking at CE and ischemic stroke, two manifestations of cardiovascular disease, separately.

Keywords: Cardiovascular disease; Competing risk analysis; Epidemiology; Ischemic stroke; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Hazard ratios (95% CI) for ischemic stroke and coronary events in relation to risk factors in MDCS
Fig. 2
Fig. 2
Hazard ratios (95% CI) for ischemic stroke and coronary events per 1SD change in inflammatory markers in MDC-CV
See this image and copyright information in PMC

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