TY - JOUR
TI - Etiology of first-ever ischaemic stroke in European young adults: the 15
cities young stroke study
AU - Barlas, N. Yesilot
AU - Putaala, J.
AU - Waje-Andreassen, U. and
AU - Vassilopoulou, S.
AU - Nardi, K.
AU - Odier, C.
AU - Hofgart, G. and
AU - Engelter, S.
AU - Burow, A.
AU - Mihalka, L.
AU - Kloss, M.
AU - Ferrari, J.
AU - and Lemmens, R.
AU - Coban, O.
AU - Haapaniemi, E.
AU - Maaijwee, N. and
AU - Rutten-Jacobs, L.
AU - Bersano, A.
AU - Cereda, C.
AU - Baron, P. and
AU - Borellini, L.
AU - Valcarenghi, C.
AU - Thomassen, L.
AU - Grau, A. J. and
AU - Palm, F.
AU - Urbanek, C.
AU - Tuncay, R.
AU - Durukan Tolvanen, A.
AU - van
AU - Dijk, E. J.
AU - de Leeuw, F. -E.
AU - Thijs, V.
AU - Greisenegger, S. and
AU - Vemmos, K.
AU - Lichy, C.
AU - Bereczki, D.
AU - Csiba, L.
AU - Michel, P.
AU - and Leys, D.
AU - Spengos, K.
AU - Naess, H.
AU - Tatlisumak, T.
AU - Bahar,
AU - S. Z.
JO - European Journal of Paediatric Neurology
PY - 2013
VL - 20
TODO - 11
SP - 1431-1439
PB - Wiley
SN - 1090-3798
TODO - 10.1111/ene.12228
TODO - cerebral infarct; etiology; ischaemic stroke (IS); stroke in young
adults
TODO - Background and purposeRisk factors for IS in young adults differ between
genders and evolve with age, but data on the age- and gender-specific
differences by stroke etiology are scare. These features were compared
based on individual patient data from 15 European stroke centers.
MethodsStroke etiology was reported in detail for 3331 patients aged
15-49years with first-ever IS according to Trial of Org in Acute Stroke
Treatment (TOAST) criteria: large-artery atherosclerosis (LAA),
cardioembolism (CE), small-vessel occlusion (SVO), other determined
etiology, or undetermined etiology. CE was categorized into low- and
high-risk sources. Other determined group was divided into dissection
and other non-dissection causes. Comparisons were done using logistic
regression, adjusting for age, gender, and center heterogeneity.
ResultsEtiology remained undetermined in 39.6%. Other determined
etiology was found in 21.6%, CE in 17.3%, SVO in 12.2%, and LAA in
9.3%. Other determined etiology was more common in females and younger
patients, with cervical artery dissection being the single most common
etiology (12.8%). CE was more common in younger patients. Within CE,
the most frequent high-risk sources were atrial fibrillation/flutter
(15.1%) and cardiomyopathy (11.5%). LAA, high-risk sources of CE, and
SVO were more common in males. LAA and SVO showed an increasing
frequency with age. No significant etiologic distribution differences
were found amongst southern, central, or northern Europe.
ConclusionsThe etiology of IS in young adults has clear gender-specific
patterns that change with age. A notable portion of these patients
remains without an evident stroke mechanism according to TOAST criteria.
Click here for the corresponding questions to this CME article.
ER -