Subtypes of Ischemic Stroke and Vascular Risk Factors up to the Age of 50 – a Prospective Study

Česká verzia

Authors: A. Bártková ¹; D. Šaňák ¹; R. Herzig ¹; I. Vlachová ¹; J. Zapletalová ²; M. Král ¹; P. Hluštík ¹; P. Kaňovský ¹
Authors place of work: LF UP v Olomouci Iktové centrum, Neurologická klinika FN Olomouc ¹; LF UP v Olomouci Ústav lékařské biofyziky a statistiky ²
Published in the journal: Cesk Slov Neurol N 2010; 73/106(2): 143-149
Category: Original Paper

Summary

Background:
Multiple risk factors (RF’s) have a role to play in the aetiology of ischemic stroke (IS), a disorder of considerable socio‑economic impact, in non‑elderly patients in their productive years. The aim of this study was to evaluate the aetiological subtypes of IS in non‑elderly (≤50 years) adults, its occurrence, and the type of vascular risk factors in different sex and age subgroups.

Methods:
The set consisted of 96 consecutive non‑elderly patients (55 males; mean age 40 years ± 8.2) with first ischemic stroke (85.4%) or transient ischemic attack (14.6%) fromamong the total of 1,450 IS patients admitted to the Olomouc Teaching Hospital between January 2004 and December 2008. Detailed medical history, head magnetic resonance imaging/computedtomography, electrocardiography, transoesophageal echocardiography and coagulation examination were performed in all patients. Patients were divided by sex and into three age subgroups (<30, 31–40, 41–50 years). Stroke subtype was assessed in terms of the TOAST criteria. For statistical analysis, Pearson’s chi‑square test and Fisher’s exact test with Bonferroni correction for multiple comparisons were employed.

Results:
The following IS subtypes were diagnosed: atherosclerotic macroangiopathy in two patients (2.3%), small vessel disease in 19 (19.2%), cardioembolism in 22 (22.9%), other determined causes in 23 (23.2 %) and undetermined cause in 30 (31.2%). Arterial hypertension was present in 50.0% of patients, hyperlipidemia (HLP) in 43.0%, cardioembolic source in 42.0%, smoking in 39.5%, diabetes mellitus in 15.6% and thrombophilia in 21.9%. HLP occurrence was significantly higher in the 41–50 age subgroup (47.9%, p = 0.048). Traditional stroke risk factors appeared more frequently among males, significantly HLP (54.5%, p = 0.007) and smoking (62.5%, p = 0.0001).

Conclusions:
Traditional stroke RFs, especially hypertension, occurred frequently in the non‑elderly IS population, particularly in males.

Key words:
ischemic stroke – age – aetiological subtype of ischaemic stroke – vascular risk factors

Zdroje

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