Karoliina Aarnio1, Bob Siegerink2, Jani Pirinen2, Juha Sinisalo2, Mika Lehto2, Elena Haapaniemi2, Alexander-Heinrich Nave2, Markku Kaste2, Turgut Tatlisumak2, Jukka Putaala2. 1. From Clinical Neurosciences (K.A., E.H., M.K., T.T., J. Putaala), Neurology, University of Helsinki; Department of Neurology (K.A., E.H., M.K., T.T., J. Putaala), Helsinki University Central Hospital, Finland; Center for Stroke Research Berlin (CSB) (B.S., A.-H.N.), Charité Universitätsmedizin Berlin, Germany; Department of Cardiology (J. Pirinen, J.S., M.L.), Heart and Lung Center, Helsinki University Hospital, Finland; Institute of Neurosciences and Physiology (T.T.), Sahlgrenska Academy, University of Gothenburg; and Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden. karoliina.aarnio@helsinki.fi. 2. From Clinical Neurosciences (K.A., E.H., M.K., T.T., J. Putaala), Neurology, University of Helsinki; Department of Neurology (K.A., E.H., M.K., T.T., J. Putaala), Helsinki University Central Hospital, Finland; Center for Stroke Research Berlin (CSB) (B.S., A.-H.N.), Charité Universitätsmedizin Berlin, Germany; Department of Cardiology (J. Pirinen, J.S., M.L.), Heart and Lung Center, Helsinki University Hospital, Finland; Institute of Neurosciences and Physiology (T.T.), Sahlgrenska Academy, University of Gothenburg; and Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract
OBJECTIVES: To study the long-term risk of recurrent cardiac, arterial, and venous events in young stroke patients, and whether these risks differed between etiologic subgroups. METHODS: The study population comprised 970 patients aged 15-49 years from the Helsinki Young Stroke Registry (HYSR) who had an ischemic stroke in 1994-2007. We obtained follow-up data until 2012 from the Finnish Care Register and Statistics Finland. Cumulative 15-year risks were analyzed with life tables, whereas relative risks and corresponding confidence intervals (CI) were based on hazard ratios (HR) from Cox regression analyses. RESULTS: There were 283 (29.2%) patients with a cardiovascular event during the median follow-up of 10.1 years (range 0.1-18.0). Cumulative 15-year risk for venous events was 3.9%. Cumulative 15-year incidence rate for composite vascular events was 34.0 (95% CI 30.1-38.2) per 1,000 person-years. When adjusted for age and sex, patients with an index stroke caused by high-risk sources of cardioembolism had the highest HR for any subsequent cardiovascular events (3.7; 95% CI 2.6-5.4), whereas the large-artery atherosclerosis group had the highest HR (2.7; 95% CI 1.6-4.6) for recurrent stroke compared with patients with stroke of undetermined etiology. CONCLUSIONS: The risk for future cardiovascular events after ischemic stroke in young adults remains high for years after the index stroke, in particular when the index stroke is caused by high-risk sources of cardioembolism or large-artery atherosclerosis.
OBJECTIVES: To study the long-term risk of recurrent cardiac, arterial, and venous events in young strokepatients, and whether these risks differed between etiologic subgroups. METHODS: The study population comprised 970 patients aged 15-49 years from the Helsinki Young Stroke Registry (HYSR) who had an ischemic stroke in 1994-2007. We obtained follow-up data until 2012 from the Finnish Care Register and Statistics Finland. Cumulative 15-year risks were analyzed with life tables, whereas relative risks and corresponding confidence intervals (CI) were based on hazard ratios (HR) from Cox regression analyses. RESULTS: There were 283 (29.2%) patients with a cardiovascular event during the median follow-up of 10.1 years (range 0.1-18.0). Cumulative 15-year risk for venous events was 3.9%. Cumulative 15-year incidence rate for composite vascular events was 34.0 (95% CI 30.1-38.2) per 1,000 person-years. When adjusted for age and sex, patients with an index stroke caused by high-risk sources of cardioembolism had the highest HR for any subsequent cardiovascular events (3.7; 95% CI 2.6-5.4), whereas the large-artery atherosclerosis group had the highest HR (2.7; 95% CI 1.6-4.6) for recurrent stroke compared with patients with stroke of undetermined etiology. CONCLUSIONS: The risk for future cardiovascular events after ischemic stroke in young adults remains high for years after the index stroke, in particular when the index stroke is caused by high-risk sources of cardioembolism or large-artery atherosclerosis.
Authors: Robert G Kowalski; Juliet K Haarbauer-Krupa; Jeneita M Bell; John D Corrigan; Flora M Hammond; Michel T Torbey; Melissa C Hofmann; Kristen Dams-O'Connor; A Cate Miller; Gale G Whiteneck Journal: Stroke Date: 2017-06-13 Impact factor: 7.914
Authors: Renate M Arntz; Mayte E van Alebeek; Nathalie E Synhaeve; Jeske van Pamelen; Noortje Amm Maaijwee; Hennie Schoonderwaldt; Maureen J van der Vlugt; Ewoud J van Dijk; Loes Ca Rutten-Jacobs; Frank-Erik de Leeuw Journal: Eur Stroke J Date: 2016-10-14
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
Authors: Jenna Broman; Karoliina Aarnio; Anna But; Ivan Marinkovic; Jorge Rodríguez-Pardo; Markku Kaste; Turgut Tatlisumak; Jukka Putaala Journal: Ann Med Date: 2022-12 Impact factor: 5.348
Authors: Myrna M E van Dongen; Karoliina Aarnio; Nicolas Martinez-Majander; Jani Pirinen; Juha Sinisalo; Mika Lehto; Markku Kaste; Turgut Tatlisumak; Frank-Erik de Leeuw; Jukka Putaala Journal: Ann Med Date: 2019-02-14 Impact factor: 4.709