Temporal Distribution of Onset of Acute Ischemic Stroke in Athens, Greece: Role of Major Predisposing Factors and Association with Ambient Temperature

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Abstract
In order to determine the temporal distribution of the onset of acute ischemic stroke in Athens, Greece, the possible role of major risk factors and the association with ambient temperature, we analyzed data collected prospectively from 234 patients with a first-ever acute ischemic stroke. A significant (p < 0.001) diurnal distribution of strokes was found: midnight–06.00h: 71 (30.3%); 06.00 h–noon: 90 (38.5%) with the peak in the 08.00–10.00 h interval; noon–18.00h: 37 (15.8%), and 18.00 h–midnight: 36 (15.3%). 25% of strokes occurred within the first hour after awakening, and a further 25% in the next 2 h. Diabetics displayed a different, statistically significant (p 20.7°C; p = 0.001) and also during ''cold'' months (average temperature < 13.4°C; p = 0.05) although to a lesser extent. The effect of temperature was not altered when sex, age, hypertension and diabetes were taken into account.

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