STROKE STATS

1
STROKE STATS

• Third leading cause of death
• 160 000 deaths a year
• 731 000 strokes a year
• 4 400 000 stroke survivors
• Leading cause of adult disability

Source Stroke Facts 1999 NSA
2
Prevalence of stroke by age and sexUnited
States 1988-94
Heart Disease and Stroke Statistics 2003
Update. Dallas, TX AHA 2002.
3
Increase in risk
MI Stroke
Initial event
Coronary artery
Myocardial infarction
Cerebrovascular
Ischemic stroke
Peripheral vascular
PAD
Adult Treatment Panel II National Cholesterol
Education Program Circulation 1994
891333-1435Kannel WB. J. Cardiovascular Risk
1994 1333-339 Wilterdink et al., Arch Neurol
199249857-863 Criqui et al., N. Engl. J. Med.
1992 326381-386
4
Long-term risk of a cardiovascular event
following a TIA
CV death, MI or stroke
CHD death or MI
Any stroke
Clark et al. J Neurol Neurosurg Psychiatry
200374577-580
5
Prevalence of IVUS-detected atherosclerotic
coronary artery disease
Prevalence ()
262 healthy donor heart transplants
Age (years)
Tuzcu EM. Circulation 20011032705
6
Stenosis severity by angiography of
atherosclerotic disease preceding MI
patients
Pre-MI Stenosis
100
200
14
gt70
50-70
18
lt 50
68
0
0
Ambrose 1985
Little 1988
Nobuyoshi 1991
Giroud 1992
All
E Falk, PK Shah, V Fuster. Circulation 199592657
7
Clinical presentation of atherosclerosis Just
the tip of the iceberg
Clinical atherosclerosis CAD CVA PAD
Subclinical Hyperinsulinemia Dyslipidemia Inflamma
tion Platelet activation Hypercoagulable Endotheli
al dysfunction Oxidative stress