Etiological classification of ischemic stroke in young patients: a comparative study of TOAST, CCS, and ASCO

Background and Objective: Evidence indicates that genetic factors may be involved in the risk of ischemic stroke (IS). The aim of this study was to assess the effect of genetic polymorphisms located in exons or untranslated regions of MTHFR as well as FV genes on ischemic stroke. Materials and Methods: In this case-control study, 106 patients with IS and 157 healthy volunteers (age <50 years) were genotyped for MTHFR C677T, A1298C, C2572A and C4869G, FVL, and prothrombin G20210A polymorphisms. Results: The MTHFR 677CT genotype was more frequent in patients and increased risk of IS with Odds Ratio = 1.9. The MTHFR A1298C and C2572A polymorphisms were not associated with IS in dominant and recessive models. Our findings showed a significant decrease in the MTHFR 4869CG genotype in IS patients, and this variant was associated with a decreased risk of IS in the dominant model. The CAAT haplotype was associated with increased risk, and the GAAC haplotype was associated with decreased risk of IS compared to other haplotypes. There was no relation between FVL G1691A polymorphism and IS risk. Conclusions: The present study showed that the MTHFR 677CT genotype was more frequent and the MTHFR 4869CG genotype was less frequent in young IS patients.

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Risk factors and prognosis of ischemic stroke in young patients in Uzbekistan

Medical and Health Science Journal ◽

10.15208/mhsj.2011.75 ◽

2011 ◽

Vol 5 ◽

pp. 16-22

Author(s):

Dilshod Sagatov ◽

Khurshidakhon Rasulova ◽

Yakutkhon Madjidova

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Young Patients ◽

Stroke In Young

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Increased Risk of Ischemic Stroke in Young Patients with Ankylosing Spondylitis: A Population-Based Longitudinal Follow-Up Study

PLoS ONE ◽

10.1371/journal.pone.0094027 ◽

2014 ◽

Vol 9 (4) ◽

pp. e94027 ◽

Cited By ~ 19

Author(s):

Chia-Wei Lin ◽

Ya-Ping Huang ◽

Yueh-Hsia Chiu ◽

Yu-Tsun Ho ◽

Shin-Liang Pan

Keyword(s):

Ischemic Stroke ◽

Ankylosing Spondylitis ◽

Young Patients ◽

Population Based ◽

Follow Up Study ◽

Increased Risk ◽

Stroke In Young

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Influence of Interleukin-6 (IL-6) Promoter Gene Polymorphisms (−174G>C, −572G>C, and −597G>A) on IL-6 Plasma Levels and Their Impact in the Development of Acute Ischemic Stroke in Young Indians

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619854136 ◽

2019 ◽

Vol 25 ◽

pp. 107602961985413

Author(s):

Mohammad Suhail Akhter ◽

Arijit Biswas ◽

Saleh Mohammed Abdullah ◽

Yahya Hobani ◽

Ravi Ranjan ◽

...

Keyword(s):

Ischemic Stroke ◽

Interleukin 6 ◽

Plasma Levels ◽

Inflammatory Marker ◽

Young Patients ◽

Enzyme Linked Immunosorbent Assay ◽

P Value ◽

Promoter Polymorphisms ◽

Genetic Components ◽

Stroke In Young

This study aimed to determine whether there is an influence of interleukin 6 ( IL-6) gene promoter polymorphisms on IL-6 plasma levels and its role in the development of ischemic stroke in young Indians. One hundred young patients with ischemic stroke (age ≥ 45 years) and equal number of age- and sex-matched controls were genotyped for 174G>C, −572G>C, and −597G>A promoter polymorphisms by polymerase chain reaction–restriction fragment length polymorphism. Plasma IL-6 levels were measured by enzyme-linked immunosorbent assay. Plasma IL-6 levels were significantly higher in patients as compared to controls (patients: 28.61 ± 8.61 pg/mL, controls: 7.60 ± 4.10 pg/mL, P = .001). Both −174G>C (allelic χ2/ P value: 4.79/.028, genotypic χ2/ P value: 5.3/.021) and −572G>C (allelic χ2/ P value: 9.63/.00113 Genotypic χ2/ P value: 74/.0002) polymorphisms exhibited genotypic as well as allelic significant association with the disease phenotype. Comparison was made between patients and controls for all 3 polymorphisms using a recessive model with respect to plasma IL-6 levels; no polymorphism showed any significant correlative association with the increased IL-6 levels ( P = .31, .51, .32). Interleukin 6 is an inflammatory marker that is considerably influenced by nongenetic factors and is not a good candidate gene for studying genetic components associated with ischemic stroke. It seems that the variability in IL-6 levels is an integrated effect of nongenetic influences and the inflammatory events that follow ischemic stroke instead of being its cause. It is suggested that there is no direct association between −174G>C, −572G>C, and −597G>A polymorphisms and elevated IL-6 levels in the development of ischemic stroke.

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Risk factors and etiological classification of ischemic stroke in young adults in Tunisia: A cohort study

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.118698 ◽

2021 ◽

Vol 429 ◽

pp. 118698

Author(s):

Manel Akkari ◽

Mariem Messelmani ◽

Hajer Derbali ◽

Malek Mansour ◽

Jamel Zaouali ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Cohort Study ◽

Ischemic Stroke ◽

Stroke In Young Adults ◽

Stroke In Young

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Analysis of Risk Factors Associated with Stroke in Young Adults: A Prospective Study

Journal of Dhaka Medical College ◽

10.3329/jdmc.v18i2.6265 ◽

1970 ◽

Vol 18 (2) ◽

pp. 95-99 ◽

Cited By ~ 1

Author(s):

MZ Hossain ◽

SU Ahmed ◽

MH Sarder ◽

R Dasgupta ◽

A Das ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Heart Disease ◽

Ischemic Stroke ◽

Cerebral Infarction ◽

Young Patients ◽

Premature Atherosclerosis ◽

Stroke In Young Adults ◽

Common Risk Factors ◽

Stroke In Young

Objective: Stroke in young patients is not common. The purpose of this study was to find out the risk factors of stroke in young adults in Bangladesh and to compare with different other studies. Methods: 85 young adult cases of stroke patients with the age ranging from 14 to 45 years, admitted in different medical units of Dhaka Medical College Hospital from January 2008 to July 2009, were studied. The risk factors for stroke and the distribution of stroke types were analyzed. Results: The specific age group (14-45 years old) included 6% of patients of all ages admitted for stroke. Among 85 patients, cerebral infarction was diagnosed in 52 patients (61%). Intracerebral hemorrhage (without trauma) was diagnosed in 25 patients (29.4%). Subarachnoid hemorrhage was found in 7 young patients (8.24%). The most common risk factors for ischemic stroke were hypertension (57.68%), hypercholesterolemia (38.46%), diabetes (34.61%), smoking (32.69%), premature atherosclerosis (11.54%). Regarding aetiology of cerebral infarction, the majority due to cardiogenic emboli (75%). The use of oral contraceptives, pregnancy, SLE, migraine and moya moya disease were infrequent causes of cerebral infarction. In ischemic stroke, the ratio of cardiogenic emboli & other factors were 3:1. The most common risk factors for hemorrhagic stroke were hypertension (63.63%), hypercholesterolemia (39.39%), diabetes (36.54%) & smoking (33.33%). Conclusion: Hypertension, Diabetes, tobacco smoking, premature atherosclerosis & rheumatic valvular heart disease are growing problems in the developing countries. According to our finding, identification & treatment of hypertension, dyslipidaemia, diabetes & rheumatic valvular heart disease & cessation of smoking are proper measures to prevent morbidity & mortality. Key words: Risk factors; stroke; young adult. DOI: 10.3329/jdmc.v18i2.6265 J Dhaka Med Coll. 2009; 18(2) : 95-99

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A Four-Year Observational Study regarding the Characteristics and Causes of the Ischemic Stroke in Young Adults: one center study report

Balneo Research Journal ◽

10.12680/balneo.2020.385 ◽

2020 ◽

pp. 491-493

Author(s):

Cătălin Cosmin MUTU ◽

Marius-Ionuț GHINCEA ◽

Corina SUCIU ◽

Vlad SUCIU

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Young Patients ◽

Carotid Artery Dissection ◽

Vascular Risk Factors ◽

Artery Dissection ◽

Vascular Risk ◽

Stroke Subtype ◽

Toast Classification ◽

Stroke In Young

Introduction. Stroke is the second cause of mortality worldwide, after the ischemic coronary disease, and the first cause of long term-disability. Recent studies report that ischemic stroke (IS) in young patients is increasing in incidence, even though the overall stroke hospitalization rate is decreasing. Stroke in the young, working individuals significantly affects the quality of life (QoL) and also determines an important, negative economic impact by reducing the workforce. Material and method. The aim of this paper is to present the results of a 4-year observational, retrospective study on all patients between 18-49 years, who suffered from acute IS and were admitted and investigated in the Neurology Clinic of Sibiu and the CVASIC Research Center. Clinical evaluations, imaging investigations, and risk factor evaluations were performed on all patients in order to elucidate the etiology and organize according to the TOAST classification. Results and discussions. 114 patients with ischemic stroke were included in the study. 76% of the subjects fall into the 40-49 age class. In respect to the TOAST classification, most cases of IS were of UE (rural<urban), while the fewest cases of IS were represented by SAA in both populations. The most frequent vascular risk factors were hypertension, dyslipidemia, smoking and thrombophilia. Confirmed cervical arteries dissection caused 2/3 of the severe carotid stenosis and 45,5% of the carotid occlusions. Conclusions. Hypertension, dyslipidemia and smoking are the main risk factors for stroke in young patients. The most common TOAST stroke subtype was stroke of undetermined etiology, followed by stroke of other determined etiology (carotid artery dissection and thrombophilia). Keywords: ischemic stroke, young patients, vascular risk factors, TOAST classification, disability,

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Analysis of the contribution of -5t/c polymorphism in the GP1BA gene to the development of ischemic stroke in young patients

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2012-419 ◽

2012 ◽

Vol 0 (4) ◽

pp. 39 ◽

Cited By ~ 1

Author(s):

V I Skvortsova ◽

E A Koltsova ◽

Ekaterina Igorevna Kimelfeld ◽

S A Limborskaya ◽

P A Slominsky ◽

...

Keyword(s):

Ischemic Stroke ◽

Young Patients ◽

Stroke In Young

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Acute stroke in young patients positive for COVID-19: A report of six cases

Neurology Asia ◽

10.54029/2021fna ◽

2021 ◽

Vol 26 (3) ◽

pp. 585-589

Author(s):

Esma Kobak Tur ◽

Eren Gözke

Keyword(s):

Ischemic Stroke ◽

Young Patients ◽

Onset Time ◽

National Institutes Of Health ◽

Vessel Occlusion ◽

Young Males ◽

Cerebrovascular Risk ◽

The Mean ◽

Polymerase Chain ◽

Stroke In Young

We report here 6 young patients of stroke with COVID-19 infection. These patients were positive for COVID-19, as confirmed using reverse transcription-polymerase chain reaction (RT-PCR) The patients’ mean age was 44.5 ± 1 years, and 83% were young males without cerebrovascular risk factors. Five patients had an ischemic stroke, one patient had intracranial hemorrhage. The mean stroke onset time was 10.2 ± 6.1 days after the COVID-19 diagnosis. Two patients were symptom-free for COVID-19. The mean National Institutes of Health Stroke Scale (NIHSS) score was 9.1 ± 5.3. Three patients had severe COVID-19 pneumonia. Large vessel occlusion was detected in 3 patients with ischemic stroke. Two patients were treated with intravenous thrombolytic, one patient underwent a mechanical thrombectomy, and an elective stent was fitted on another patient. In conclusion, COVID-19 should be considered as a possible cause particularly in young strokes during the pandemic period.

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Association of Dyslipidaemia in Young Patients with Recent Ischaemic Stroke

Bangladesh Journal of Neuroscience ◽

10.3329/bjn.v31i2.57379 ◽

2015 ◽

Vol 31 (2) ◽

pp. 56-64

Author(s):

Mostafa Hosen ◽

Md Rafiqul Islam ◽

Abu Nasir Rizvi ◽

Moniruzamman Bhuyian

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Young Adult ◽

Family History ◽

Serum Lipids ◽

Smoking Habit ◽

Young Patients ◽

Vascular Risk ◽

History Of ◽

Stroke In Young

Background: The relation between serum lipids and ischemic stroke remains controversial in young patients. The aim was to determine the serum lipid profile and the vascular risk factors for ischaemic stroke in a series of patients under 45 with an ischemic stroke and to compare them with a series of controls of the same age. Material and method: This case-control study was conducted in the Department of Neurology and Department of Biochemistry of BSMMU, Dhaka, between the period of July 2007 and June 2009 for duration of two years. A total number of 50 patients presented with recent ischemic stroke and 50 control person were enrolled in this study. All patients of both sexes, aged between 15 to 45 years presented with ischemic stroke, from 0 day to 1 month that was confirmed by CT scan of head/MRI of brain. Vascular risk factors were recorded and blood sample was collected from the cases and the controls and analyzed at the Dept. of Biochemistry, BSMMU for estimation of serum fasting lipid profile. Result: Multivariate analyses showed that other than serum lipids- family history of dyslipidaemia, family history of stroke or TIA, history of HTN and smoking habit are found significant risks for stroke in young adult. Conclusion: The present study does not confirm the role of serum lipids as risk factors for ischemic stroke in young adult. Other than serum lipids- family history of dyslipidaemia, family history of stroke or TIA, history of HTN and smoking habit are found significant risks for stroke in young adult. Bangladesh Journal of Neuroscience 2015; Vol. 31 (2): 56-64

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