Distribution of etiologies in patients above and below age 45 with first-ever ischemic stroke

Telman, Gregory; Kouperberg, Efim; Sprecher, Elliot; Yarnitsky, David

doi:10.1111/j.1600-0404.2007.00953.x

Cited by 25 publications

(22 citation statements)

References 30 publications

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“…These have suggested sex differences in risk factor distribution 4 -7 and higher frequencies of vascular risk factors in older age groups of young adult patients with stroke. 4,[7][8][9][10][11][12] Particularly in young adults, sex-and age-specific differences have awaited investigations on a larger scale, for instance, to gather more generalizable and usable information for young-onset stroke prevention.…”

mentioning

confidence: 99%

Demographic and Geographic Vascular Risk Factor Differences in European Young Adults With Ischemic Stroke

Putaala

Yeşilot

Waje‐Andreassen

et al. 2012

Stroke

147

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Background and Purpose-We compared among young patients with ischemic stroke the distribution of vascular risk factors among sex, age groups, and 3 distinct geographic regions in Europe. Methods-We included patients with first-ever ischemic stroke aged 15 to 49 years from existing hospital-or population-based prospective or consecutive young stroke registries involving 15 cities in 12 countries. Geographic regions were defined as northern (Finland, Norway), central (Austria, Belgium, France, Germany, Hungary, The Netherlands, Switzerland), and southern (Greece, Italy, Turkey) Europe. Hierarchical regression models were used for comparisons. Results-In the study cohort (nϭ3944), the 3 most frequent risk factors were current smoking (48.7%), dyslipidemia (45.8%), and hypertension (35.9%). Compared with central (nϭ1868; median age, 43 years) and northern (nϭ1330; median age, 44 years) European patients, southern Europeans (nϭ746; median age, 41 years) were younger. No sex difference emerged between the regions, male:female ratio being 0.7 in those aged Ͻ34 years and reaching 1.7 in those aged 45 to 49 years. After accounting for confounders, no risk-factor differences emerged at the region level. Compared with females, males were older and they more frequently had dyslipidemia or coronary heart disease, or were smokers, irrespective of region. In both sexes, prevalence of family history of stroke, dyslipidemia, smoking, hypertension, diabetes mellitus, coronary heart disease, peripheral arterial disease, and atrial fibrillation positively correlated with age across all regions. Conclusions-Primary preventive strategies for ischemic stroke in young adults-having high rate of modifiable risk factors-should be targeted according to sex and age at continental level. (Stroke. 2012;43:2624-2630.)

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mentioning

confidence: 99%

Demographic and Geographic Vascular Risk Factor Differences in European Young Adults With Ischemic Stroke

Putaala

Yeşilot

Waje‐Andreassen

et al. 2012

Stroke

147

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“…Only just reports from 2002 to 2012 years have shown a great diversity in TOAST subtypes in young IS patients ( Table 5) [26][27][28][29][30][31][32][33][34][35][36][37][38][39]. In addition to differences in research design, areas, composition and sources of patients, sample size, and other factors, it was assumed that this diversity also may be due to the fact that the aetiology of young stroke is more complex than that of elderly patients and that the TOAST classification is not suitable for young stroke [40]. A previous study showed that nontraditional causes including dissections and thrombophilias were the most frequent in distribution of aetiologies by TOAST in young IS [40].…”

Section: Subtype Constituents Of Ismentioning

confidence: 99%

“…In addition to differences in research design, areas, composition and sources of patients, sample size, and other factors, it was assumed that this diversity also may be due to the fact that the aetiology of young stroke is more complex than that of elderly patients and that the TOAST classification is not suitable for young stroke [40]. A previous study showed that nontraditional causes including dissections and thrombophilias were the most frequent in distribution of aetiologies by TOAST in young IS [40]. Another study on IS of unusual cause enrolled 70 patients and showed hematological disorders in 17 cases, infection in 11, migraine stroke in 10, cerebral infarction secondary to venous thrombosis in 9, primary inflammatory vascular conditions in 6 and miscellaneous causes in 17, and an age of 45 years or less was one of independent predictors of the stroke [41].…”

Section: Subtype Constituents Of Ismentioning

confidence: 99%

Classification analysis of young stroke in zhuhai city, China

Li¹,

Wang²,

Luo³

et al. 2013

Neurosci Discov

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Background: The morbidity and mortality rates in young Chinese stroke patients have increased, and the appropriate classification of stroke is very important to identifying the cause, pathogenesis, severity, outcome, and preventive and therapeutic strategies. This study sought to analyse the young stroke subtype in a coastal city Zhuhai of southern China. Methods: Hospitalised young stroke patients in the two largest local hospitals were retrospectively analysed from July 2002 to July 2009. The percentage of every stroke subtype was calculated. Results: A total of 416 young stroke patients (age 18-45 years) were included. There were 225 (54.1%) cases of ischemic stroke (IS), 145 (34.9%) cases of intracerebral haemorrhage (ICH), 38 (9.1%) cases of subarachnoid haemorrhage (SAH), and 8 (1.9%) cases of mixed stroke (MS). Cases of IS were divided into four groups using the OCSP criteria: 15 (6.7%) total anterior circulation infarcts (TACI), 117 (52.0%) partial anterior circulation infarcts (PACI), 61 (27.1%) lacunar infarcts (LACI ), and 32 (14.2%) posterior circulation infarcts (POCI). Cases of IS were divided into five groups using the TOAST criteria: 14 (6.2%) cases of large-artery atherosclerosis (LAA), 15 (6.7%) cases of cardioembolism (CE), 108 (48 %) cases of small-artery occlusion (SAO), 16 (7.1%) cases of stroke of other determined aetiologies (SOE), and 72 (32%) cases of stroke of undetermined aetiology (SUE). Conclusions:The results suggested that within the locality, the majority of cases of young stroke were IS and ICH, and the minority were SAH and MS; additionally, the most common IS subtypes were PACI, LACI or SAO and SUE, which could contribute to the local prevention and control of stroke.

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“…Onset time was defined as the first appearance of abnormal signs that were noticed by the treating team in the intensive care unit or in the cardiothoracic-surgery department. Ischemic strokes and intracerebral hemorrhages were differentiated by the findings on brain CT, performed in all patients between days 1 and 8 after stroke onset since MRI is not routinely performed for assessment of stroke in Israel [11,12]. Ischemic stroke etiology was determined using the TOAST classification [13,14].…”

Section: Methodsmentioning

confidence: 99%

The Possible Risk for Strokes Complicating Cardiac Surgery in Patients with Intraoperative Hypothermia

Korn‐Lubetzki

Steiner²,

Oren³

et al. 2010

Cerebrovasc Dis

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Background: The effect of hypothermia as a possible neuroprotective tool on the outcome of cardiac surgery is still controversial. Methods: We retrospectively assessed all patients who underwent cardiac surgery within a 14-year period and compared patients with and without postoperative stroke. Results: Stroke occurred more frequently in patients who underwent valve repair/replacement combined with coronary artery bypass grafting (CABG) than in patients who had CABG alone (p = 0.0002). All strokes (1.4%) were ischemic and mostly of large-vessel etiology. All patients with stroke had intraoperative minimal temperature <34°C. More patients in this group than in the group without stroke had an intraoperative minimal temperature <30°C (p = 0.01). Stepwise multivariate analysis of all pre- and intraoperative parameters identified significant risk factors for stroke: hypertension, diabetes mellitus and previous stroke as preoperative risk factors, but only lower minimal temperature as a significant intraoperative risk factor (p = 0.03; odds ratio 1.080/1°C, 95% confidence interval 1.004–1.152). The mean intraoperative temperature was 28 ± 4°C in patients who developed stroke and 30 ± 3°C in patients without stroke. Conclusions: Intraoperative hypothermia around 28°C might be harmful and associated with increased risk for postsurgical stroke.

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Distribution of etiologies in patients above and below age 45 with first-ever ischemic stroke

Cited by 25 publications

References 30 publications

Demographic and Geographic Vascular Risk Factor Differences in European Young Adults With Ischemic Stroke

Demographic and Geographic Vascular Risk Factor Differences in European Young Adults With Ischemic Stroke

Classification analysis of young stroke in zhuhai city, China

The Possible Risk for Strokes Complicating Cardiac Surgery in Patients with Intraoperative Hypothermia

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