Abstract 12233: Ethnic Trends of Acute Ischemic Stroke Incidence and Risk Factors in a Multiethnic Population in Southeast Asia: A 12-year Study Using a Nationwide Stroke Registry

IntroductionEthnicity has been shown to affect acute ischemic stroke (AIS) incidence, risk factors, treatment effectiveness, complications and functional outcomes. This study aims to describe these differences across the main ethnic groups of Singapore.HypothesisThere are differences in AIS incidenc...

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Published in:Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A12233-A12233
Main Authors: Cheah, Dawn, Tan, Benjamin Y, Pek, Pin Pin, Huili, Zheng, De Silva, Deidre A, Ahmad, Aftab, Chan, Bernard P, Hui Meng, Chang, Keng, Kong, Young, Sherry, Tang, Kok Foo, Yeo, Leonard L, Venketasubramanian, Narayanaswamy, Ho, Andrew, Ong, Marcus E
Format: Article
Language:English
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Summary:IntroductionEthnicity has been shown to affect acute ischemic stroke (AIS) incidence, risk factors, treatment effectiveness, complications and functional outcomes. This study aims to describe these differences across the main ethnic groups of Singapore.HypothesisThere are differences in AIS incidence, risk factors and outcomes between ethnicities.MethodsData of AIS cases between 2005-2016 was obtained from the national Singapore Stroke Registry. This data was divided into the 4 major ethnic groups - Chinese, Malay, Indian and other ethnicities.Results60,325 cases were recorded. While overall AIS crude incidence increased over the years, that of the Malays was consistently higher since 2007 (223.6 per 100,00 in 2016) compared to Chinese (178.1), Indians (152.2), and other ethnicities (123.8). Risk factors also varied significantly. In particular, the prevalence of atrial fibrillation was lower in Indians (10.5%), approximately half that of the Chinese (21.1%), Malays (18.8%) and others (19.0%). Prevalence of diabetes mellitus was significantly higher in Malays (55.9%) and Indians (64.2%) compared to Chinese (41.8%) and others (46.2%). Prevalence of pre-morbid ischemic heart disease was higher amongst Indians (36.4%) compared to Chinese (22.4%), Malays (27.4%), and others (29.4%). However, treatment provided (antiplatelets, anticoagulation and thrombolysis utilization rates), in-hospital treatment targets and outcomes (door-to-needle, door-to-CT timings, NIHSS improvement, inpatient complications, mortality) were similar across ethnicities.ConclusionsDespite ethnic disparities in incidence and risk factors, it is notable that acute treatment and inpatient outcome measures of timing, morbidity and mortality show little variance between ethnicities. It would be worth targeting future policies aimed at primary prevention to better address the epidemiological variance of AIS risk factors between different ethnicities.
ISSN:0009-7322
1524-4539
DOI:10.1161/circ.140.suppl_1.12233