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Infection and risk of ischemic stroke: differences among stroke subtypes
A Paganini-Hill1, E Lozano, G Fischberg
1Department of Preventive Medicine of the Keck School of Medicine of the University of Southern California, Los Angeles, USA. annliahi@usc.edu
Stroke
|February 8, 2003
Summary
Recent respiratory infections may trigger ischemic stroke, particularly in individuals without common vascular risk factors. This finding highlights infection as a potential stroke risk, especially for large-vessel or cardioembolic types.
Area of Science:
- Neurology
- Epidemiology
- Infectious Diseases
Background:
- The link between infection and stroke risk is not fully understood, despite previous studies indicating infections in 25-35% of stroke patients.
- Investigating infectious/inflammatory syndromes as potential stroke risk factors is crucial for understanding stroke etiology.
Purpose of the Study:
- To investigate the association between infectious/inflammatory syndromes and the risk of ischemic stroke.
- To characterize the specific impact of recent infections on different stroke subtypes.
Main Methods:
- A case-control and crossover study design was employed, including 233 ischemic stroke cases and 363 controls.
- Subjects underwent neurological examinations, infection/inflammation assessments, and interviews to gather history within days of stroke onset and again two months later.
- Physicians classified I/I status based on examinations, interviews, and laboratory results.
Main Results:
- No increased frequency of overall or specific infections was observed in stroke cases compared to controls.
- Patients with recent respiratory tract infections showed a higher incidence of large-vessel atherothromboembolic or cardioembolic stroke (48% vs. 24%).
- The relative risk for these stroke subtypes was elevated, particularly in individuals without traditional stroke risk factors like hypertension or diabetes. Patients with respiratory infections also presented with more severe neurological deficits.
Conclusions:
- Respiratory tract infection may serve as a trigger for large-vessel and/or cardioembolic ischemic stroke.
- The risk appears heightened in individuals lacking common vascular risk factors.
- These findings suggest infection control could be a potential stroke prevention strategy.
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