scholarly journals Prevalence and outcome of young stroke patients with middle cerebral artery stenosis

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenjuan Xu ◽  
Xiaoyu Zhang ◽  
Huan Chen ◽  
Zhangning Zhao ◽  
Meijia Zhu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Factor Score ◽  
Unfavorable Outcome ◽  
Stroke Patients ◽  
Young Stroke ◽  
Stroke In Young Adults ◽  
Risk Factor Score ◽  
Stroke In Young

Abstract Background Etiologies of acute ischemic stroke in young adults are heterogeneous. Middle cerebral artery (MCA) stenosis is a common finding in Asians which may be an important cause of stroke in young adults. However, studies of stroke in young Asian populations are rare. Our study was to investigate the prevalence and outcome of young stroke patients with MCA stenosis in Chinese populations. Methods Young patients with MCA territory infarction between January 2013 and September 2018 were retrospectively recruited. Subjects were defined as stenosis group (MCA stenosis ≥50%) and no-stenosis group (MCA stenosis<50% or no stenosis) by their MCA stenosis. For patients in stenosis group, they were categorized as uni-MCA stenosis subgroup and multiple stenosis subgroup. Demographic data, risk factors, imaging feature and complications were compared between groups. Prevalence of MCA stenosis and risk factor score (score ≥ 2 or 3) in different age groups were investigated. Modified Rankin Scale (mRS) was used for evaluating functional outcome at discharge (unfavorable outcome: 3–6). Binary logistic regression was performed to determine independent risk factors of unfavorable outcome. Results Two hundred forty-nine young stroke patients were included in our study and 110 (44.2%) patients were defined as stenosis group. 55 (50%) patients were categorized as uni-MCA stenosis subgroup and 55 (50%) were multiple stenosis subgroup. The most common traditional vascular risk factors included hypertension, hyperlipemia, smoking, hyperhomocysteinemia and alcohol consumption. Prevalence of risk factor score ≥ 2 or 3 increased with age, but not incidence of MCA stenosis. By TOAST classification, the most common etiologies were large-artery atherosclerosis (41.0%) and small vessel disease (33.7%). Compared with no-stenosis group, patients in stenosis group were more likely to have large territorial infarct, develop complications and have unfavorable outcome. No significant difference was found between patients in uni-MCA stenosis and multiple stenosis subgroups except history of stroke/TIA, risk factor score ≥ 3 and silent infarct. By logistic regression, hypertension (OR = 3.561; 95%CI, 1.494 to 8.492; p = 0.004), NIHSS scores at admission (OR = 1.438; 95%CI, 1.276 to 1.620; p = 0,000) and infarct size (p = 0.015) independently predicted unfavorable outcome. Conclusions Forty-four point two percent young Chinese adults with MCA territory infarction had MCA stenosis. Prevalence of MCA stenosis did not increase with age. Patients with MCA stenosis had worse clinical outcome, however, only hypertension, NIHSS scores at admission and infarct size were independent predictors.

scholarly journals Global Outcome Assessment Life-long after stroke in young adults initiative—the GOAL initiative: study protocol and rationale of a multicentre retrospective individual patient data meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031144
Author(s):  
Merel Ekker ◽  
Mina Jacob ◽  
Myrna van Dongen ◽  
Karoliina Aarnio ◽  
Arunkar Annamalai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Secondary Prevention ◽  
Stroke Risk ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Stroke Patients ◽  
Young Stroke ◽  
Stroke In Young Adults ◽  
Stroke In Young

IntroductionWorldwide, 2 million patients aged 18–50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients.Methods and analysisThe Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18–50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence.Ethics and disseminationEthical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.

scholarly journals Trends in the co-occurrence of cardiovascular risk factors by education in Finland, 1997–2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Paalanen ◽  
T Härkänen ◽  
J Kontto ◽  
H Tolonen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Factor Score ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Education Group ◽  
Educational Differences ◽  
Risk Factor Score ◽  
Education Groups ◽  
Over Time

Abstract Background Understanding on sociodemographic variation of the co-occurrence of cardiovascular disease (CVD) risk factors is crucial for planning public health policy and future prevention strategies. We aimed at examining 1) the co-occurrence of smoking, hypertension, elevated cholesterol and obesity by education, and 2) the trends in educational differences in the co-occurrence of these risk factors in Finland. Methods We used cross-sectional health examination surveys carried out every five years among the general adult population: for 1997-2012 the National FINRISK Study and for 2017 the FinHealth 2017 Survey. Respondents aged 25-64 years were included in the analyses (n = 25,036). Current smoking, obesity (BMI≥30 kg/m2), hypertension (≥140/≥90 mmHg or medication) and elevated serum total cholesterol (≥5.0 mmol/l or medication) were used for the risk factor accumulation score with categories 1) zero, 2) one, 3) two, and 4) three or four elevated risk factors. Multinomial logistic regression was used to estimate predicted probabilities for each category. Results Overall, the risk factor score was more favourable among women than men, and among high education groups than low education groups in both sexes. The lowest risk factor score class became more prevalent in all education groups in both sexes over time. The change in educational differences was not significant. However, the intermediate education group approached the highest education group over time. Conclusions Our data indicate an overall transition towards a more favourable risk factor score in Finland, in 1997-2017. The score among the intermediate education group approached that among the highest education group. The tendency of risk factor accumulation among those with least education remained during the study period, which raises a need to develop and implement interventions and public health policies that would be effective in decreasing the risk factor burden particularly in this group. Key messages Overall, a favourable trend of diminishing risk factor prevalence was seen. The tendency of accumulation of major CVD risk factors among the least educated subjects remained from 1997 to 2017.

scholarly journals Erratum to: Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS)

2015 ◽  
Vol 263 (1) ◽  
pp. 199-200 ◽  
Author(s):  
Barbara Goeggel Simonetti ◽  
Marie-Luise Mono ◽  
Uyen Huynh-Do ◽  
Patrik Michel ◽  
Celine Odier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischaemic Stroke ◽  
Young Stroke ◽  
Stroke In Young Adults ◽  
Stroke Study ◽  
Stroke In Young

scholarly journals P.090 Risk factors and etiology of stroke in young adults: a 6-years retrospective hospital-based study, OMAN

2018 ◽  
Vol 45 (s2) ◽  
pp. S40-S40
Author(s):  
AM Al Hashmi ◽  
S Jose ◽  
S Al Mawali
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Chart Review ◽  
Young Patients ◽  
Life Time ◽  
Royal Hospital ◽  
Stroke In Young Adults ◽  
Single Center Study ◽  
Stroke In The Young ◽  
Stroke In Young

Background: Stroke in the young is particularly tragic because of its potential for life time disability. Although a large number of studies have been published Worldwide. Very few have looked at etiologies in the youth of the Middle East,and none have focused on Oman. Methods: Retrospective,single center study,carried out at the Royal Hospital in Muscat. Chart review identifying all patients under 50 years of age admitted for acute stroke from 2009-2014. We analyzed the detailed history,examination and brain imaging (CT or MRI) for each case. We identified 588 young patients,163 of these were excluded due to other diagnosis or absence of neuroimaging (CT or MRI). Results: Out of the 425 stroke cases,67.3% were men. IS occurred in 69.6% compared to 30.4% for HS. Hypertension was the number one risk factor for both IS and HS,with a prevalence 50.7% and 60.5% respectively. DM was the second leading risk factor,with a prevalence of 32.1% in IS and 27.1% in HS. Underlying etiologies were identified in only 35.5% of cases in IS and 29.5% in HS.Cardiac etiology and vasculopathy were commonest for IS. Aneurysm was the main underlying etiology for HS. Conclusions: IS was more frequent than HS.Hypertension and DM were the leading risk factors for both stroke subtypes. Cardioembolism and vasculopathy were the main etiologies for IS.Cerebral aneurysm for HS.

scholarly journals Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS)

2015 ◽  
Vol 262 (9) ◽  
pp. 2025-2032 ◽  
Author(s):  
Barbara Goeggel Simonetti ◽  
Marie-Luise Mono ◽  
Uyen Huynh-Do ◽  
Patrik Michel ◽  
Celine Odier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischaemic Stroke ◽  
Young Stroke ◽  
Stroke In Young Adults ◽  
Stroke Study ◽  
Stroke In Young

Associations of Leisure Time, Commuting, and Occupational Physical Activity With Physical Fitness and Cardiovascular Risk Factors in Young Men

2014 ◽  
Vol 11 (8) ◽  
pp. 1482-1491 ◽  
Author(s):  
Jani P. Vaara ◽  
Heikki Kyröläinen ◽  
Mikael Fogelholm ◽  
Matti Santtila ◽  
Arja Häkkinen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Physical Fitness ◽  
Cardiovascular Risk Factors ◽  
Leisure Time ◽  
Factor Score ◽  
Cvd Risk ◽  
Risk Factor Score

Background:The aim was to study the relationships between different domains of physical activity and cardiovascular risk factors and physical fitness.Methods:781 young men participated. Self-reported leisure-time (LTPA), commuting (CPA) and occupational (OPA) activity were determined. Blood pressure, s-HDL-cholesterol, s-triglycerides and s-LDL-cholesterol, and glucose were measured. The continuous cardiovascular disease (CVD) risk factor score was calculated from the z-score mean of each cardiovascular risk factor. The cutpoint was defined as 1 standard deviation above the mean. Cardiorespiratory and muscular fitness were measured.Results:The likelihood of CVD risk factor score was higher in moderate [OR 1.99 (95% CI 1.21–3.28)] and low [1.87 (1.16–3.02)] CPA groups compared with the high group, whereas neither low nor moderate LTPA or OPA groups showed similar associations after adjustments. Low OPA combined either with low LTPA [2.01 (1.08–3.74)] or low CPA [1.90 (1.05–3.44)] had a higher likelihood for CVD risk factor compared with combined moderate-high categories after adjustments. LTPA was positively associated with all physical fitness parameters, CPA with cardiorespiratory fitness and muscular endurance, and OPA with grip strength.Conclusion:The results emphasize the beneficial role of CPA regarding CVD risk factor score and stress the avoidance of low physical activity in its different domains.

Risk factors for febrile neutropenia and the utilization of pegfilgrastim in patients receiving chemotherapy for gynecologic malignancies

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16063-16063
Author(s):  
T. M. Numnum ◽  
S. Bryant ◽  
E. Williams ◽  
L. Kilgore ◽  
J. M. Straughn
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Febrile Neutropenia ◽  
Factor Score ◽  
Primary Prophylaxis ◽  
Gynecologic Malignancies ◽  
Outpatient Chemotherapy ◽  
The Mean ◽  
Risk Factor Score ◽  
Mean Risk

16063 Background: Recently published gudelines for the use of granulocyte-colony stimulating factors define risk factors for the development of febrile neutropenia (FN) in patients receiveing chemotherapy. Our objective is to assess the risk factors associated with FN and the utilization of pegfilgrastim (G-CSF) for the prevention of FN in patients receiving chemotherapy for gynecologic malignancies. Methods: A computerized database identified all outpatient chemotherapy encounters over a 4 month period. Risk factors for FN (adapted from guidelines published by ASCO) were determined for each chemotherapy encounter and a risk factor score was calculated (1–17). Each chemotherapy encounter was analyzed to determine if G-CSF was administered and the reason for utilization. Dose delays/modifications were also determined. Statistical comparisons were performed using the χ2 test. Results: 692 chemotherapy encounters were identified in 209 patients. 77 % of patients had a diagnosis of ovarian cancer. The mean risk factor score was 3.9 (range 1–9). The most common risk factors were: female (100%), advanced cancer (81%), prior chemotherapy (54%), and age > 65 yo (46%). 276 of the 692 (40%) encounters utilized G-CSF. 135 patients (49%) received G-CSF as primary prophylaxis for the development of FN; 141 patients (51%) received G-CSF after an episode of Grade 3 or 4 neutropenia. The mean risk factor score was 4.3 in patients receiving primary prophylaxis. After primary prophylaxis, 1 dose delay/modification for neutropenia was experienced versus 14 dose delays/modifications without prophylaxis (p <0.01). There were 12 dose delays/modifications due to thrombocytopenia in patients receiving PP. There was only one episode of FN. 64% of patients receiving primary prophylaxis were treated with a docetaxel-containing regimen and 61% of patients were receiving primary chemotherapy. Conclusions: G-CSF is utilized in 40% of chemotherapy encounters and is commonly associated with docetaxel-containing regimens. Dose delays/modifications are uncommon after primary prophylaxis with G-CSF in patients receiving chemotherapy for gynecologic malignancies. No significant financial relationships to disclose.

scholarly journals Risk Factors in Young Stroke

2019 ◽  
Vol 21 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Md Harun Ur Rashid ◽  
MA Kashem ◽  
Sarmistha Biswas ◽  
Mohammad Mahfuzul Hoque
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Young Patients ◽  
The Elderly ◽  
Cross Sectional ◽  
Medical College ◽  
Stroke In Young Adults ◽  
Associated Risk Factors ◽  
The Individual ◽  
Stroke In Young

Background: Stroke in young age is less frequent than in older populations but has a major impact on the individual and society. This study was done to find out aetiological pattern and associated risk factors of stroke in young adults. Methods: This descriptive cross-sectional observational study was conducted in the Department of Medicine and Neurology, Dhaka Medical College, Dhaka, during the period of April to October 2016. We studied consecutive 100 stroke patients between the age of 15-45 years. Results: In this study 62% patients were male and 38% were female, male incidence is 24% higher than female and ratio is 1. 38. Infarction was found in 65% cases. Haemorrhage was in 35% cases. Dyslipidaemia was mostly associated risk factor in both infarction (76. 91%) and in haemorrhage (85. 71%). High prevalence of dyslipidaemia as associated risk factor may indicate premature atherosclerosis. Conclusion: Stroke in young requires a different approach to investigation and management than stroke in the elderly due to differences in the relative frequencies of possible underlying causes. It remains the case, however, that atherosclerosis contributes to a large proportion of stroke in young patients, thus conventional risk factors must be targeted aggressively. J MEDICINE JAN 2020; 21 (1) : 26-30

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