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Risk factors in lacunar syndromes: a case-control study
C Gandolfo1, C Caponnetto, M Del Sette
1Department of Neurology, University of Genoa, Italy.
Acta Neurologica Scandinavica
|January 1, 1988
Summary
This study identified key risk factors for lacunar syndromes, finding hypertension, diabetes, smoking, and previous transient ischemic attacks (TIA) significantly increase risk. However, other factors like atrial fibrillation and high cholesterol were not associated in this patient cohort.
Area of Science:
- Neurology
- Epidemiology
- Cardiovascular Research
Background:
- Lacunar syndromes are often linked to small vessel disease, primarily affecting the penetrating arteries.
- Identifying specific risk factors is crucial for understanding the pathogenesis and preventing lacunar stroke.
- Previous studies have suggested various risk factors, but their specific association with lacunar syndromes requires further investigation.
Purpose of the Study:
- To evaluate the association between several hypothetical risk factors and lacunar syndromes.
- To determine the relative risk (RR) of developing lacunar syndromes based on specific patient characteristics.
- To explore potential alternative pathogenetic mechanisms in lacunar syndrome cases without hypertension.
Main Methods:
- A matched case-control study design was employed.
- 108 incident cases of lacunar syndrome were compared with 216 hospital controls, matched for sex and age.
- Risk factors assessed included: previous TIA, hypertension, ECG ischemic abnormalities, diabetes, smoking, atrial fibrillation, hypercholesterolemia, hypertriglyceridemia, and high hematocrit.
Main Results:
- Significant increases in Relative Risk (RR) were observed for: previous TIA, hypertension, smoking, and diabetes.
- No significant association was found between lacunar syndromes and atrial fibrillation, hypercholesterolemia, hypertriglyceridemia, or high hematocrit.
- In hypertensive patients, analysis revealed increased RR for TIA, ischemic cardiac abnormalities, and atrial fibrillation, suggesting different underlying mechanisms.
Conclusions:
- Hypertension, diabetes, smoking, and a history of TIA are significant risk factors for lacunar syndromes.
- Factors such as atrial fibrillation, hypercholesterolemia, hypertriglyceridemia, and high hematocrit do not appear to be independently associated with lacunar syndromes in this cohort.
- A subset of lacunar syndrome cases, particularly those without hypertension, may involve pathogenetic mechanisms distinct from the typical occlusion of penetrating arteries.