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Supplementary Material for: Specificities of Ischemic Stroke Risk Factors in Arab-Speaking Countries
<p><b><i>Background:</i></b> Stroke is largely preventable, and
therefore, a better understanding of risk factors is an essential step
in reducing the population stroke rate and resulting disease burden in
Arab countries. <b><i>Summary:</i></b> We performed 2 separate analyses
in 2 similar populations of patients with noncardioembolic ischemic
stroke. This first involved 3,635 patients in the Outcomes in Patients
with TIA and Cerebrovascular disease (OPTIC) registry (followed for 2
years), with baseline collection of the usual risk factors and 5
socioeconomic variables (unemployment status, residence in rural area,
living in fully serviced accommodation, no health-insurance coverage,
and low educational level). The second involved patients in the PERFORM
trial (<i>n</i> = 19,100 followed up for 2 years), with baseline
collection of the usual risk factors and 1 socioeconomic variable (low
educational level). The primary outcome was a composite of nonfatal
stroke, nonfatal myocardial infarction, or cardiovascular death. Stroke
risk factors were more prevalent in patients in Arab countries. The
incidence of major cardiovascular events (MACE; age- and
gender-adjusted) was higher in Arab countries (OPTIC, 18.5 vs. 13.3%;
PERFORM, 18.4 vs. 9.7%; both <i>p </i>≤ 0.0001). These results remained
significant after adjustment on risk factors and were attenuated in
OPTIC after further adjustment on socioeconomic variables (hazard ratio
1.24; 95% CI 0.98-1.55; <i>p </i>= 0.07). <b><i>Key Messages:</i></b>
Patients with ischemic stroke living in Arab countries had a lower mean
socioeconomic status, a much higher prevalence of diabetes mellitus, and
a higher rate of MACE compared with patients from non-Arab countries.
This finding is partly explained by a higher prevalence of risk factors
and also by a high prevalence of poverty and low educational level.</p