Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank
Abstract
BACKGROUND AND PURPOSE: Data on risk factors for etiologic subtypes of ischemic stroke are still scant. The aim of this study was to characterize stroke subtypes regarding risk factor profile, outcome, and current treatment strategies. METHODS: We analyzed data from 5017 patients with acute ischemic stroke (42.4% women, aged 65.9+/-14.1 years) who were enrolled in a large multicenter hospital-based stroke data bank. Standardized data assessment and stroke subtype classification were used by all centers. RESULTS: Sex and age distribution, major risk factors and comorbidities, recurrent stroke, treatment strategies, and outcome were all unevenly distributed among stroke subtypes (P<0.001, respectively). Cardioembolism, the most frequent etiology of stroke (25.6%), was particularly common in the elderly (those aged >70 years) and associated with an adverse outcome, a low rate of early stroke recurrence, and frequent use of thrombolytic therapy and intravenous anticoagulation. Large-artery atherosclerosis (20.9%), the most common cause of stroke in middle-aged patients (those aged 45 to 70 years), showed the highest male preponderance, highest rate of early stroke recurrence, and highest prevalence of previous transient ischemic attack, current smoking, and daily alcohol consumption among all subtypes. The highest prevalence of hypertension, diabetes mellitus, hypercholesterolemia, and obesity was found in small-vessel disease (20.5%), which, in turn, was associated with the lowest stroke severity and mortality. CONCLUSIONS: Our results foster the concept of ischemic stroke as a polyetiologic disease with marked differences between subtypes regarding risk factors and outcome. Therefore, studies involving risk factors of ischemic stroke should differentiate between etiologic stroke subtypes.
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The highest risk of recurrent stroke is in the early phase after a first stroke or TIA.
“The highest risk of recurrent stroke is in the early phase after a first stroke or TIA.469, 470”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [469]
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Self-citation
- Authors
- Grau, A. J., Weimar, C., Buggle, F., Heinrich, A., Goertler, M., Neumaier, S., Glahn, J., Brandt, T., Hacke, W., & Diener, H.-C.
- Affiliations
- Heidelberg University (DE)
- Venue
- Stroke
- Published
- 2001-11-01
- Volume
- 32
- Issue
- 11
- Pages
- 2559-2566
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2128143634
- Cited by
- 998
- References
- 33
- Citations by year
- 2026: 12 · 2025: 21 · 2024: 30 · 2023: 30 · 2022: 43 · 2021: 51 · 2020: 60 · 2019: 53 · 2018: 59 · 2017: 48 · 2016: 71 · 2015: 55 · 2014: 48 · 2013: 60 · 2012: 45
- FWCI
- 13.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
- Keywords
- ischemic stroke, stroke subtypes, cardiac embolism, large artery atherosclerosis, cerebral small vessel disease, risk factors, stroke outcome, stroke recurrence, thrombolysis, intravenous anticoagulation, transient ischemic attack, hypertension, diabetes mellitus, hypercholesterolemia, obesity, sex differences, age differences
- MeSH terms
- Adult, Aged, Brain Ischemia, Female, Germany, Humans, Male, Middle Aged, Prognosis, Risk Factors, Databases, Factual, Stroke
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