Intracranial Atherosclerosis Clinical Trial
Official title:
Asymptomatic Intracranial Atherosclerotic Disease: Prevalence, Clinical and Lifestyle Determinants in Urban Pakistan
The incidence of stroke has increased by 100% in the last four decades in developing countries like Pakistan. Intracranial atherosclerotic disease (ICAD) is the most frequent causative subtype of ischemic stroke in the world including Pakistan. ICAD is progressive narrowing of the arteries at the base of the brain due to atherosclerosis. After a stroke from ICAD, recurrence rate is highest in any sub-type of stroke, up to 28% with limited therapeutic options. Therefore, it is imperative to delineate the determinants of asymptomatic ICAD prior to stroke. Investigators hypothesized that there is at least a 20% difference in the proportion of clinical, life-style (dietary, physical activity, obesity, smoking and stress/depression), and socio-economic predictors of asymptomatic ICAD than those with no ICAD.
Stroke is a major emerging cause of adult disability and the 3rd leading non-communicable
cause of mortality in the world . With half of the world's population living in Asia, stroke
epidemiology and its risk factor determination is important globally. The changes in
population demographics and continuing industrialization in Asia have also led to a change
in the epidemiology of stroke sub-types . Among the ischemic stroke sub-types, Intracranial
Atherosclerotic disease is now emerging as the most prevalent vascular cause of stroke with
high prevalence in Asian, African and Hispanic individuals .
Patients with ICAD are at a significant risk for recurrent stroke, with a risk as high as
25% in the first two years . Rate of recurrent stroke also varies by the location of the
affected artery. Risk factor management is extremely important for the primary and secondary
prevention of stroke in Asia as it is in Western countries. With the changing demographics
and relatively fewer cost effective treatment modalities available, particularly for
resource poor countries like Pakistan, it is imperative to delineate the clinical as well as
lifestyle risk factors at an earlier asymptomatic stage to prevent future life-threatening
consequences.
Therefore the primary objective of this study is to determine the clinical, lifestyle,
dietary and psycho-social determinants of asymptomatic Intracranial Atherosclerotic disease
(ICAD) and its other associated Brain MRI findings namely brain volume reduction, silent
brain infarcts, and peri-ventricular hyper intensities in clinically normal adults with ICAD
on MRI Brain.
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