BACKGROUND AND PURPOSE: Risk 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. METHODS: Stroke etiology was reported in detail for 3331 patients aged 15-49 years 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. RESULTS: Etiology 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. CONCLUSIONS: The 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.
BACKGROUND AND PURPOSE: Risk 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. METHODS:Stroke etiology was reported in detail for 3331 patients aged 15-49 years 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. RESULTS: Etiology 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. CONCLUSIONS: The 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.
Authors: Barbara Goeggel Simonetti; Marie-Luise Mono; Uyen Huynh-Do; Patrik Michel; Celine Odier; Roman Sztajzel; Philippe Lyrer; Stefan T Engelter; Leo Bonati; Henrik Gensicke; Christopher Traenka; Barbara Tettenborn; Bruno Weder; Urs Fischer; Aekaterini Galimanis; Simon Jung; Rudolf Luedi; Gian Marco De Marchis; Anja Weck; Carlo W Cereda; Ralf Baumgartner; Claudio L Bassetti; Heinrich P Mattle; Krassen Nedeltchev; Marcel Arnold Journal: J Neurol Date: 2015-06-12 Impact factor: 4.849
Authors: Noortje A M M Maaijwee; Loes C A Rutten-Jacobs; Pauline Schaapsmeerders; Ewoud J van Dijk; Frank-Erik de Leeuw Journal: Nat Rev Neurol Date: 2014-04-29 Impact factor: 42.937
Authors: Turgut Tatlisumak; Jukka Putaala; Markus Innilä; Christian Enzinger; Tiina M Metso; Sami Curtze; Bettina von Sarnowski; Alexandre Amaral-Silva; Gerhard Jan Jungehulsing; Christian Tanislav; Vincent Thijs; Arndt Rolfs; Bo Norrving; Franz Fazekas; Anu Suomalainen; Edwin H Kolodny Journal: J Neurol Date: 2015-11-14 Impact factor: 4.849
Authors: Jukka Putaala; Nicolas Martinez-Majander; Sahrai Saeed; Nilufer Yesilot; Pekka Jäkälä; Ossi Nerg; Georgios Tsivgoulis; Heikki Numminen; Daniel Gordin; Bettina von Sarnowski; Ulrike Waje-Andreassen; Pauli Ylikotila; Risto O Roine; Marialuisa Zedde; Juha Huhtakangas; Catarina Fonseca; Petra Redfors; Frank-Erik de Leeuw; Alessandro Pezzini; Janika Kõrv; Siim Schneider; Christian Tanislav; Christian Enzinger; Dalius Jatuzis; Bob Siegerink; Patricia Martínez-Sánchez; Armin J Grau; Frederick Palm; Per-Henrik Groop; Sylvain Lanthier; Hugo Ten Cate; Pirkko Pussinen; Susanna Paju; Juha Sinisalo; Mika Lehto; Arne Lindgren; José Ferro; Steven Kittner; Franz Fazekas; Eva Gerdts; Turgut Tatlisumak Journal: Eur Stroke J Date: 2017-04-04