Lacunar infarction was associated with a marginal excess of hypertension compared to nonlacunar infarction (RR 1.11; 95% CI 1.04-1.19) when using risk factor-free subtype definitions.
Systematic Review (n=28)
Are risk factor profiles different between patients with lacunar versus nonlacunar infarction?
When using risk factor-free classification methods, there is little evidence of differences in risk factor profiles between lacunar and nonlacunar stroke subtypes.
Relative Risk: 1.11 (95% CI 1.04–1.19)
BACKGROUND AND PURPOSE: Differences in risk factors between lacunar and nonlacunar infarcts might support a distinct arterial pathological process underlying lacunar infarction. METHODS: We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calculated study-specific and pooled relative risks (RRs) for lacunar versus nonlacunar infarction. RESULTS: A total of 16 of 28 studies included risk factors in their ischemic stroke subtype definitions. Hypertension and diabetes appeared commoner among patients with lacunar versus nonlacunar infarction. However, analyses confined to studies using risk factor-free ischemic subtype definitions found only a marginal excess of hypertension with lacunar versus nonlacunar infarction (RR, 1.11; 95% CI, 1.04 to 1.19) and no difference for diabetes (RR, 0.95; 95% CI, 0.83 to 1.09). Atrial fibrillation and carotid stenosis were associated more with nonlacunar than lacunar infarction but less so when only studies using risk factor-free classifications were considered. Otherwise, there was no evidence of differences in risk factor profiles. CONCLUSIONS: Risk factor-free ischemic stroke subtype classification methods should be used for comparing risk factor profiles between lacunar and nonlacunar subtypes.
Jackson et al. (Fri,) conducted a systematic review in Ischemic stroke (lacunar vs nonlacunar infarction) (n=28). Lacunar infarction vs. Nonlacunar infarction was evaluated on Hypertension (in studies using risk factor-free definitions) (RR 1.11, 95% CI 1.04 to 1.19). Lacunar infarction was associated with a marginal excess of hypertension compared to nonlacunar infarction (RR 1.11; 95% CI 1.04-1.19) when using risk factor-free subtype definitions.