Circadian variation in acute ischemic stroke among Iraqi patients

Globally, acute ischemic stroke is a major cause of morbidity and mortality that has a substantial effect on quality of life and public health systems. An increasing amount of data points to the role of circadian rhythms – the endogenous, roughly 24-hour cycles that govern a number of physiological and behavioral processes in humans – in the incidence and severity of acute ischemic stroke. Objective: to study the relationship between circadian patterns and ischemic stroke onset regarding theischemicstroke subtypes. Material and methods. This was a cross sectional study included 192 patients diagnosed with ischemic stroke.The data collected were age, gender, past medical history, family history, social history, medication history, symptom onset time, imaging findings, and chronic illness. Results . The mean age of patients was 64.8±12.5 years. Large-artery atherosclerosis and cardioembolisim were the most common ischemic stroke subtype, accounted for 46.9% and 29.7% respectively, while 23.4% were small vessel occlusion (lacunar). Furthermore, anterior circulation was the most common site of stroke (77%). The most common time of stroke was at morning between 7:00–11:59 AM (36.98%) followed by 1:00–6:00 AM. There is significant association between type and time of stroke where most of large-artery atherosclerosis strokes (72.2%) and cardioembolism strokes (57.9%) were between 12:00–11:59 AM while the small vessel occlusion strokes (lacunar) were mostly between 12:00–11:59 PM. Conclusion. The observed circadian pattern of ischemic stroke, which shows a peak occurrence in the morning between 7:00–11:59 AM, has been supported by this study. Small vessel occlusion strokes (lacunar) had a less clear pattern than Large-artery atherosclerosis and cardioembolisim type, which showed strong morning predominance. There were no discernible correlations between the time of a stroke and vascular or sociodemographic risk variables.