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ISSN 1561-3011 (Electronic)

2016, Number 4

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Rev Cubana Invest Bioméd 2016; 35 (4)

Risk factors and etiologies of the stroke in 20 to 55 years-old patients

Vargas FD, Miranda JL, Fernández CL, Jiménez CM, Clemente Jaime I

Language: Spanish
References: 38
Page: 341-353
PDF size: 286.51 Kb.


ABSTRACT

Introduction: Stroke in patients aged 20 to 55 years is an event of great impact. Several unusual atherothrombotic risk factors and different etiologies are involved in the pathogenesis of the lesion, which gives rise to a variety of stroke subtypes. Many risk factors and etiologies have been studied but the results are unclear and/or discordant.
Objective: To identify the risk factors for stroke and the etiological subtypes according to the Trial of Org 10 172 in Acute Stroke Treatment (TOAST) criteria in patients aged 20 to 55 years.
Methods: A retrospective, cross-sectional and descriptive research study was conducted in 175 patients diagnosed with stroke and aged 20 to 55 years. They had been admitted to "Hermanos Ameijeiras" clinical and surgical hospital from January 1st 2004 to September 30th 2014.
Results: The average age was 46 ± 7.6 years and males predominated. The atherothrombotic stroke (45.71 %) was the most common TOAST subtype. The most frequent factors were blood hypertension, dyslipidemias, smoking, alcohol consumption and overweight. For the cardioembolic origin (14.86 %), the main one was atrial fibrillation followed by myocardial infarction whereas for the unusual origin (16.57 %), the hypercoagulation alterations predominated. The undetermined origin accounted for 13.71 % of cases.
Conclusions: Blood hypertension was the most frequent risk factors for all types of strokes and the atrial fibrillation was the predominant cardioembolic etiology; atherothrombotic stroke was the most common.


REFERENCES

  1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 18 Jan 2014;383(9913):245-54.

  2. Mukherjee D, Patil CG. Epidemiology and the global burden of stroke. World Neurosurg. 2011 Dec;76(6 Suppl):S85-90.

  3. Bennett DA, Anderson LM, Nair N, Truelsen T, Barker-Collo S, Connor M, et al. The Global Burden of Disease Stroke Expert Group. Methodology of the Global and Regional Burden of Stroke Study. Neuroepidemiology. 2012;38:30-40.

  4. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Executive summary: heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014;29:399-410.

  5. Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurology. 2007;6:182-7.

  6. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Cuba 2015. La Habana. Organización Panamericana de la Salud. Oficina Regional de la Organización Mundial de la Salud [en línea]. 2016 [citado 30 de mayo 2016]:31. Disponible en: http://bvscuba.sld.cu/anuario-estadístico-de-cuba/

  7. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Cuba 2015. La Habana. Organización Panamericana de la Salud. Oficina Regional de la Organización Mundial de la Salud [en línea]. 2016 [citado 30 de mayo 2016]:38. Disponible en: http://bvscuba.sld.cu/anuario-estadístico-de-cuba/.

  8. Angulo AH, Cabasés-Hita JM, Forcén Alonso T. Costes del ictus desde la perspectiva social. Enfoque de incidencia retrospectiva con seguimiento a tres años. Rev Neurol. 2006;43:518-25.

  9. Mackey J. Evaluation and management of Stroke in Young Adults. Continuum (Minneap Minn). 2014;20(2):352-69.

  10. Dash D, Bhashin A, Pandit AK, Tripathi M, Bhatia R, Prasad K, et al. Risk factors and etiologies of ischemic strokes in Young patients: a tertiary hospital study in North India. Journal of Stroke. 2014;16(3):173-7.

  11. Putuaala J, Yesilot N, Waje-Andreasen U, Pikaniemi J, Vassilopoulou S, Nardi K, et al. Demographic and geographic vascular risk factors differences in European young adults with ischemic stroke: the 15 cities young stroke study. Stroke. 2012 Oct;43(10):2624-30.

  12. Maaijwee NAMM, Rutten-Jacobs LCA, chaapsmeerders P, van Dijk EJ, de Leeuw FE. Ischemic stroke in young adults: risk factores and long-term consequences. Nat Rev Neurol. 2014;(10):315-10.

  13. Starby H, Delavaran H, Andsberg G, Lovkvist H, Norrving B, Lindgren A, et al. Multiplicity if risk factors in ischemic stroke patients: relations to age, sex, andsubtype: a study of 2 505 patients from the lund stroke register. Neuroepidemiology. 2014;42(3):161-8.

  14. Sultan S, Elkind MS. The growing problem of stroke among young adults. Curr Cardiol Rep. 2013 Dec;15(12):421.

  15. Smajlovic D. Strokes in young adults: epidemiology and prevention. Vascular Health and Risk Management. 2015;(11):157-64.

  16. Renna R, Pilato F, Profice P, Della Marca G, Broccolini A, Morosetti R, et al. Risk factor and etiology analysis of ischemic stroke in young adult patients. Journal of stroke and cerebrovascular diseases. 2014 March;23(3):e221-7.

  17. Griffiths D, Sturm J. Epidemiology and etiology of young stroke. Stroke Res Treat. 2011;2011:209-370.

  18. Yamamoto FI. Ischemic stroke in young adults: an overview of etiological aspects. Arq. Neuro-Psiquiatr. 2012.

  19. Smajlovic D, Salihovic L, Ibrahimagic OC, Sinanovic O. Characteristics of stroke in young adults in Tuzla Canton, Bosnia and Herzegovina. Coll Antropol. 2013 Jun;37(2):515-9.

  20. Rodríguez-Yáñez M, Fernández C, Pérez-Concha T, Luna A, Roncero N, Castillo J, et al. Enfermedades vasculares cerebrales. En: Zarranz JJ. Neurología. 5ta edición. Barcelona: Elsevier; 2013. p. 275-326.

  21. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the Joint National Committe on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. The JNC 7 Report. JAMA 2003;289:2560-71.

  22. Kay ST, Navarro JC, Ka SW, Yi NH, Hou ChCh, Niphon P, et al. Clinical profile, risk factors and etiology of young ischemic stroke patients in Asia: a prospective multicentre, observational, hospital-based study in eight cities. Neurology Asia. 2014;19(2):117-27.

  23. Biller J, Love BB, Schneck MJ. Vascular disease of nervous system. Ischemic cerebrovascular disease. In: Daroff RB, Ferichel GM, Jankovic J, Mazziotta J. Bradley´s Neurology in clinical practice. 6th ed. Philadelphia, Elsevier. 2012. p. 1003-50.

  24. Díez-Tejedor E.Guía para el diagnóstico y tratamiento del ictus. Comité ad hoc del Grupo de estudio de Enfermedades Cerebrovasculares. Sociedad Española de Neurología. Barcelona: Prous Science; 2006.

  25. Dehlendorff C, Andersen KK, Olsen TS. Body mass index and death by stroke: no obesity paradox. JAMA Neurol. 2014 Aug;71(8):978-84.

  26. Consenso de Estenosis Carotídea. Sociedad Argentina de Cardiología. Sociedad Neurológica Argentina. Rev. Argentina Cardiol. 2006;74(2):160-74.

  27. Harrigan MR. Extracraneal cerebrovascular occlusive disease. In: Harrigan MR, Deveikis JP. Handbook of cerebrovascular disease and neurointerventional technique. New York: Humana Press; 2009. p. 641-678.

  28. Larrue V, Berhoune N, Massabuau P, Calviere L, Raposo N, Viguier A, et al. Etiologic investigation of ischemic stroke in Young adults. Neurology. 2011:76(23):1983-8.

  29. Ma B, Liu G, Chen X, Zhang J, Liu Y, Shi J, et al. Risk of stroke in patients with patent foramen ovale: an updated meta-analysis of observational studies. J Stroke Cerebrovasc Dis. 2014 May-Jun;23(5):1207-15.

  30. Katsanos AH, Spence JD, Bogiatzi C, Parissis J, Giannopoulos S. Recurrent stroke and patent foramen ovale: a systematic review and meta- analysis. Stroke. 2014 Nov;45(11):3352-9.

  31. Kishore A1, Vail A, Majid A, Dawson J, Lees KR, Tyrrell PJ, et al. Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis. Stroke. 2014 Feb;45(2):520-6.

  32. Zhu J, Su X, Li G, Chen J, Tang B, Yang Y, et al. The incidence of acute myocardial infarction in relation to overweight and obesity: a meta-analysis. Arch Med Sci. 2014 Oct 27;10(5):855-62.

  33. Chen H1, Hong H, Xing S, Liu G, Zhang A, Tan S, et al. Intracranial versus Extracranial Artery Dissection Cases Presenting with Ischemic Stroke. J Stroke Cerebrovasc Dis. 2015 Apr;24(4):852-9.

  34. Cohen JE, Itshayek E, Keigler G, Eichel R, Leker RR. Endovascular thrombectomy and stenting in the management of carotid fibromuscular dysplasia presenting with major ischemic stroke. J ClinNeurosci. 2014 Nov; 21(11):2021-3.

  35. Vukasovic I, Solter VV, Zavoreo I, Kes VB. The role of classic risk factors and prothrombotic factor gene mutations in ischemic stroke risk development in young and middle-aged individuals. J Stroke Cerebrovasc Dis. 2014 Mar;23(3):e171-6.

  36. Alleyne M, Horne MK, Miller JL. Individualized treatment for iron-deficiency anemia in adults. Am J Med. 2008;121:943-8.

  37. Chuang SY , Bai CH, Chen WH, Lien LM, Pan WH. Fibrinogen independently predicts the development of ischemic stroke in a Taiwanese population: CVDFACTS study. Stroke. 2009 May;40(5):1578-84.

  38. Brey RL. Antiphospholipid antibodies in young adults with stroke. J Thromb Thrombolysis. 2005 Oct;20(2):105-12.




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