CLINICAL EPIDEMIOLOGY OF ISCHEMIC STROKE: GLOBAL TRENDS AND REGIONAL DIFFERENCES

The aim of the study was to assess the epidemiology of clinical variants of ischemic stroke in the different countries of the world. The depth of information search is 15 years, it was performed in the databases EMBASE, PubMed, OVID, EBSCOhost, ProQuest, Google Scholar, IRBIS, РИНЦ (RISC). 30 articles were selected for further analysis. There was found that at the beginning of 2019, there were 847 RCTs in the world dedicated to the diagnosis and treatment of acute stroke, most of which were performed in Europe, the USA and China. 90 % of all cases of stroke in the world are associated with modifiable risk factors. The highest incidence rates of ischemic stroke are registered in the developing nations and post-Soviet countries. The frequency of recurrent strokes is determined by the clinical variants of the primary stroke: for POCI, the frequency of repeated strokes is 20-25%, for TACI and PACI - 17%, for LACI - 9%, and in most cases of recurrent strokes they occur in the same cerebral artery as the primary ones. Global trends in the clinical epidemiology of ischemic stroke are associated with the aging of the population, increasing role of comorbid pathology and the progress of medical diagnosticand treatment technologies. The observed regional differences could be explained by the various levels of socio-economic development and the resource base of national health systems, differences in the compliance of the applied secondary prevention, as well as by the availability of national registers and large epidemiological studies.