Common Triggers Of Ischemic Stroke:a Case Cross-over Study

Objective:To explore the correlation between 6 common triggers and ischemic stroke.With a view to guide the prevention of ischemic stroke.Methods:The data of patients with ischemic stroke in the Department of Neurology of the first hospital of Shanxi Medical University from May 2016 to October were collected,and to investigate the triggers of the disease in 4 days after admission.A case-crossover study design was used for the purpose of study.Exposure including overeating,anger,negative emotions,heavy physical activity,sudden posture changes as response to a startling event,drink coffee in 2-hour hazard period immediately before the onset of stroke was compared with the 2-hour control period at the same time on the day before the onset of stroke.Further analysis the differences of exposed triggers based on different gender,age,etiology classification.Results:1.A total of 369 patients were enrolled.there aged 24~93years old(mean61.75±13.5),220 cases were male(59.6%)and 149 were female(40.4%).A total of 91patients(24.7%)exposed to at least one triggers at 2h before onset(odds ratio [OR]6.1,95% confidence interval [CI] 3.7~9.9);OR for exposure to the sudden posture change in response to a startling event was 12.0(95%CI:2.4~59.3),for heavy physical activity10.7(95%CI:4.2~27.6),for angry 8.0(95%CI:2.3~27.5),for negative emotion 4.9(95%CI:2.3~10.3),.and for overeating 2.5(95%CI:0.82~7.61).There was no exposure to coffee drinkers.2.There was no significant difference in relative risk of the triggers based on different gender and age.The data of patients in different etiological subtypes showed that heavy physical activity triggered cardioembolism(OR7.0,95%CI:7.0~4.7),negative emotion triggered large-artery atherosclerosis(OR3.7,95%CI:1.1~12.0)and small-vessel occlusion subtypes(OR4.3,95%CI:1.1~11.8).But there was no significant differences in the exposure to various triggers among the different etiological subtypes.Conclusion:1.Sudden posture changes as response to a startling event,heavy physical activity,anger,and negative emotion are the triggers for ischemic stroke.So we should pay attention to the triggers in the work of prevention and treatment of ischemic stroke.2.There was no significant association between overeating,drinking coffee and ischemic stroke.3.There was no statistically significant difference in relative risk of the triggers based on different gender,age,etiology classification.