Subtypes of Ischemic Stroke and Vascular Risk Factors up to the Age of 50 – a Prospective Study

Authors: A. Bártková 1;  D. Šaňák 1;  R. Herzig 1;  I. Vlachová 1;  J. Zapletalová 2;  M. Král 1;  P. Hluštík 1;  P. Kaňovský 1
Authors‘ workplace: LF UP v Olomouci Iktové centrum, Neurologická klinika FN Olomouc 1;  LF UP v Olomouci Ústav lékařské biofyziky a statistiky 2
Published in: Cesk Slov Neurol N 2010; 73/106(2): 143-149
Category: Original Paper


Multiple risk factors (RF’s) have a role to play in the aetiology of ischemic stroke (IS), a disorder of considerable socio‑economic impact, in non‑elderly patients in their productive years. The aim of this study was to evaluate the aetiological subtypes of IS in non‑elderly (≤50 years) adults, its occurrence, and the type of vascular risk factors in different sex and age subgroups.

The set consisted of 96 consecutive non‑elderly patients (55 males; mean age 40 years ± 8.2) with first ischemic stroke (85.4%) or transient ischemic attack (14.6%) fromamong the total of 1,450 IS patients admitted to the Olomouc Teaching Hospital between January 2004 and December 2008. Detailed medical history, head magnetic resonance imaging/computedtomography, electrocardiography, transoesophageal echocardiography and coagulation examination were performed in all patients. Patients were divided by sex and into three age subgroups (<30, 31–40, 41–50 years). Stroke subtype was assessed in terms of the TOAST criteria. For statistical analysis, Pearson’s chi‑square test and Fisher’s exact test with Bonferroni correction for multiple comparisons were employed.

The following IS subtypes were diagnosed: atherosclerotic macroangiopathy in two patients (2.3%), small vessel disease in 19 (19.2%), cardioembolism in 22 (22.9%), other determined causes in 23 (23.2 %) and undetermined cause in 30 (31.2%). Arterial hypertension was present in 50.0% of patients, hyperlipidemia (HLP) in 43.0%, cardioembolic source in 42.0%, smoking in 39.5%, diabetes mellitus in 15.6% and thrombophilia in 21.9%. HLP occurrence was significantly higher in the 41–50 age subgroup (47.9%, p = 0.048). Traditional stroke risk factors appeared more frequently among males, significantly HLP (54.5%, p = 0.007) and smoking (62.5%, p = 0.0001).

Traditional stroke RFs, especially hypertension, occurred frequently in the non‑elderly IS population, particularly in males.

Key words:
ischemic stroke – age – aetiological subtype of ischaemic stroke – vascular risk factors


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