J Stroke.  2019 Sep;21(3):276-289. 10.5853/jos.2019.01522.

Clinical Variables and Genetic Risk Factors Associated with the Acute Outcome of Ischemic Stroke: A Systematic Review

Affiliations
  • 1Stroke Pharmacogenomics and Genetics Laboratory, Sant Pau Research Institute, Barcelona, Spain. israelcadenas@yahoo.es
  • 2Neurovascular Research Laboratory, Vall d’Hebron Research Institute (VHIR), Autonomous University of Barcelona, Barcelona, Spain.
  • 3Stroke Pharmacogenomics and Genetics Laboratory, Mutua Terrasa Foundation of Teaching and Research, Mutua Terrassa Hospital, Terrassa, Spain.
  • 4Health Care Science Department, The Manchester Metropolitan University of All Saints, Manchester, UK.
  • 5Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
  • 6Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.
  • 7Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA. leejm@wustl.edu
  • 8Department of Neurology, Virgin Rocío and Macarena Hospitals, Institute of Biomedicine of Seville (IBiS), Seville, Spain.
  • 9Stroke Unit, Department of Neurology, Saint Cross and Saint Pau Hospital, Barcelona, Spain.

Abstract

Stroke is a complex disease and one of the main causes of morbidity and mortality among the adult population. A huge variety of factors is known to influence patient outcome, including demographic variables, comorbidities or genetics. In this review, we expound what is known about the influence of clinical variables and related genetic risk factors on ischemic stroke outcome, focusing on acute and subacute outcome (within 24 to 48 hours after stroke and until day 10, respectively), as they are the first indicators of stroke damage. We searched the PubMed data base for articles that investigated the interaction between clinical variables or genetic factors and acute or subacute stroke outcome. A total of 61 studies were finally included in this review. Regarding the data collected, the variables consistently associated with acute stroke outcome are: glucose levels, blood pressure, presence of atrial fibrillation, prior statin treatment, stroke severity, type of acute treatment performed, severe neurological complications, leukocyte levels, and genetic risk factors. Further research and international efforts are required in this field, which should include genome-wide association studies.

Keyword

Stroke; Outcome; Clinical variables; Genetics

MeSH Terms

Adult
Atrial Fibrillation
Blood Pressure
Comorbidity
Genetics
Genome-Wide Association Study
Glucose
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Leukocytes
Mortality
Risk Factors*
Stroke*
Glucose
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