Risk factors and mechanisms of stroke in young adults: The FUTURE study
van Alebeek, ME
van der Vlugt, MJ
de Leeuw, FE
Journal of Cerebral Blood Flow & Metabolism
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van Alebeek, M., Arntz, R., Ekker, M., Synhaeve, N., Maaijwee, N., Schoonderwaldt, H., van der Vlugt, M., et al. (2017). Risk factors and mechanisms of stroke in young adults: The FUTURE study. Journal of Cerebral Blood Flow & Metabolism https://doi.org/10.1177/0271678X17707138
Incidence of ischemic stroke and transient ischemic attack in young adults is rising. However, etiology remains unknown in 30–40% of these patients when current classification systems designed for the elderly are used. Our aim was to identify risk factors according to a pediatric approach, which might lead to both better identification of risk factors and provide a stepping stone for the understanding of disease mechanism, particularly in patients currently classified as “unknown etiology”. Risk factors of 656 young stroke patients (aged 18–50) of the FUTURE study were categorized according to the “International Pediatric Stroke Study” (IPSS), with stratification on gender, age and stroke of “unknown etiology”. Categorization of risk factors into ≥1 IPSS category was possible in 94% of young stroke patients. Chronic systemic conditions were more present in patients aged <35 compared to patients ≥35 (32.6% vs. 15.6%, p < 0.05). Among 226 patients classified as “stroke of unknown etiology” using TOAST, we found risk factors in 199 patients (88%) with the IPSS approach. We identified multiple risk factors linked to other mechanisms of stroke in the young than in the elderly. This can be a valuable starting point to develop an etiologic classification system specifically designed for young stroke patients.
etiology, ischemic stroke, risk factors, transient ischemic attack, young stroke
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: de Leeuw is supported by a clinical established investigator grant of the Dutch Heart Foundation (grant no. 2014 T060), and by a VIDI innovational grant from The Netherlands Organisation for Health Research and Development ZonMw (grant no. 016-126-351) and has also received research support from the “Dutch Epilepsy Fund” (grant no. 2010-18); Loes Rutten-Jacobs (LR-J) is supported by a British Heart Foundation Immediate Research Fellowship (FS/15/61/31626) (www.bhf.org.uk).
British Heart Foundation (FS/15/61/31626)
External DOI: https://doi.org/10.1177/0271678X17707138
This record's URL: https://www.repository.cam.ac.uk/handle/1810/264629