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This may be particularly relevant to the periprocedural outcomes for carotid stenting where inadequate platelet inhibition may predispose to early thrombosis and embolisation with the attendant hazard of stroke.
Although primary tests of significance were based on radiation dose being modelled as a continuous risk factor, patterns of association are also described through the use of indicator variables that allow for the estimation of the relative hazard of stroke (and 95% CIs) between radiation dose strata ≥0.05 Gy versus doses considered to be small (<0.05 Gy).
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All six population based studies could be included in the meta-analysis (fig 2), which showed a significant association of white matter hyperintensities with risk of stroke (hazard ratio 3.1, 95% confidence interval 2.3 to 4.1, P<0.001).
White matter hyperintensities were associated with an increased risk of stroke (hazard ratio 3.3, 95% confidence interval 2.6 to 4.4), dementia (1.9, 1.3 to 2.8), and death (2.0, 1.6 to 2.7).
However, when the model was further adjusted for the individual components, MetS was associated with significantly increased risk of stroke (hazard ratio 1.34 [95% CI 1.07 1.68]) and all-cause mortality (1.35 [1.16 1.58]) but not coronary outcomes (fatal coronary heart disease plus nonfatal myocardial infarction 1.16 [0.95–1.43] and total coronary events 1.06 [0.91.0624]).
The hazard ratio for stroke did not change when participants with a previous cardiac event during follow-up were excluded from the analysis (hazard ratio of stroke in lipid lowering drug users 0.56 (0.41 to 0.77).
Boissel et al [ 62] in the INDANA data set that included individual patient data reported a Cox proportional hazard model of stroke in the five trials (28,997 patients, 808 events).
In an adjusted analysis, microalbuminuria increased the risk of stroke with a hazard ratio (HR) of 3.2 (1.9 5.6), macroalbuminuria 4.9 (2.9 8.2), and end-stage renal disease 7.5 (4.2–13.3), and SDR increased the risk with an HR of 3.0 (1.9 4.5).
Hazard ratios were obtained to measure the increased risk of stroke across the risk strata.
We calculated hazard ratios with 95% confidence intervals (95% CIs) for the associations between heart failure and the risk of stroke, with Cox proportional hazards models.
Results Lipid lowering drug users were at decreased risk of stroke compared with non-users (hazard ratio 0.66, 95% confidence interval 0.49 to 0.90); hazard ratios for stroke were similar for statin (0.68, 0.45 to1.01) and fibrate (0.66, 0.44 to 0.98).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com