Cervical artery dissection in young adults in the stroke in young fabry patients (sifap1) study

Bettina Von Sarnowski, Ulf Schminke, Ulrike Grittner, Franz Fazekas, Christian Tanislav, Manfred Kaps, Turgut Tatlisumak, Jukka Putaala, Karl Georg Haeusler, Alexandre Décio Borges Do Amaral E Silva, Justin A. Kinsella, Dominick J H McCabe, William Tobin, Roman Huber, Johann Willeit, Martin Furtner, Ulf Bodechtel, Arndt Rolfs, Christof Kessler, Michael G. Hennerici

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Patients with carotid artery dissection (CAD) have been reported to have different vascular risk factor profiles and clinical outcomes to those with vertebral artery dissection (VAD). However, there are limited data from recent, large international studies comparing risk factors and clinical features in patients with cervical artery dissection (CeAD) with other TIA or ischemic stroke (IS) patients of similar age and sex. Methods: We analysed demographic, clinical and risk factor profiles in TIA and IS patients ≤55 years of age with and without CeAD in the large European, multi-centre, Stroke In young FAbry Patients 1 (sifap1) study. Patients were further categorised according to age (younger: 18-44 years; middle-aged: 45-55 years), sex, and site of dissection. Results: Data on the presence of dissection were available in 4,208 TIA and IS patients of whom 439 (10.4%) had CeAD: 196 (50.1%) had CAD, 195 (49.9%) had VAD, and 48 had multiple artery dissections or no information regarding the dissected artery. The prevalence of CAD was higher in women than in men (5.9 vs. 3.8%, p < 0.01), whereas the prevalence of VAD was similar in women and men (4.6 vs. 4.7%, n.s.). Patients with VAD were younger than patients with CAD (median = 41 years (IQR = 35-47 years) versus median = 45 years (IQR = 39-49 years); p < 0.01). At stroke onset, about twice as many patients with either CAD (54.0 vs. 23.1%, p < 0.001) or VAD (63.4 vs. 36.6%, p < 0.001) had headache than patients without CeAD and stroke in the anterior or posterior circulation, respectively. Compared to patients without CeAD, hypertension, concomitant cardiovascular diseases and a patent foramen ovale were significantly less prevalent in both CAD and VAD patients, whereas tobacco smoking, physical inactivity, obesity and a family history of cerebrovascular diseases were found less frequently in CAD patients, but not in VAD patients. A history of migraine was observed at a similar frequency in patients with CAD (31%), VAD (27.8%) and in those without CeAD (25.8%). Conclusions: We identified clinical features and risk factor profiles that are specific to young patients with CeAD, and to subgroups with either CAD or VAD compared to patients without CeAD. Therefore, our data support the concept that certain vascular risk factors differentially affect the risk of CAD and VAD.

Original languageEnglish (US)
Pages (from-to)110-121
Number of pages12
JournalCerebrovascular Diseases
Volume39
Issue number2
DOIs
StatePublished - Mar 6 2015

Fingerprint

Dissection
Young Adult
Arteries
Stroke
Vertebral Artery Dissection
Carotid Arteries
Cerebrovascular Disorders
Patent Foramen Ovale
Migraine Disorders

Keywords

  • Acute ischaemic stroke
  • Carotid arteries
  • Cerebral infarcts in young adults
  • Cerebral ischaemia
  • Dissection
  • Risk factors for stroke
  • Vertebral artery dissection

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Von Sarnowski, B., Schminke, U., Grittner, U., Fazekas, F., Tanislav, C., Kaps, M., ... Hennerici, M. G. (2015). Cervical artery dissection in young adults in the stroke in young fabry patients (sifap1) study. Cerebrovascular Diseases, 39(2), 110-121. https://doi.org/10.1159/000371338

Cervical artery dissection in young adults in the stroke in young fabry patients (sifap1) study. / Von Sarnowski, Bettina; Schminke, Ulf; Grittner, Ulrike; Fazekas, Franz; Tanislav, Christian; Kaps, Manfred; Tatlisumak, Turgut; Putaala, Jukka; Haeusler, Karl Georg; Silva, Alexandre Décio Borges Do Amaral E; Kinsella, Justin A.; McCabe, Dominick J H; Tobin, William; Huber, Roman; Willeit, Johann; Furtner, Martin; Bodechtel, Ulf; Rolfs, Arndt; Kessler, Christof; Hennerici, Michael G.

In: Cerebrovascular Diseases, Vol. 39, No. 2, 06.03.2015, p. 110-121.

Research output: Contribution to journalArticle

Von Sarnowski, B, Schminke, U, Grittner, U, Fazekas, F, Tanislav, C, Kaps, M, Tatlisumak, T, Putaala, J, Haeusler, KG, Silva, ADBDAE, Kinsella, JA, McCabe, DJH, Tobin, W, Huber, R, Willeit, J, Furtner, M, Bodechtel, U, Rolfs, A, Kessler, C & Hennerici, MG 2015, 'Cervical artery dissection in young adults in the stroke in young fabry patients (sifap1) study', Cerebrovascular Diseases, vol. 39, no. 2, pp. 110-121. https://doi.org/10.1159/000371338
Von Sarnowski B, Schminke U, Grittner U, Fazekas F, Tanislav C, Kaps M et al. Cervical artery dissection in young adults in the stroke in young fabry patients (sifap1) study. Cerebrovascular Diseases. 2015 Mar 6;39(2):110-121. https://doi.org/10.1159/000371338
Von Sarnowski, Bettina ; Schminke, Ulf ; Grittner, Ulrike ; Fazekas, Franz ; Tanislav, Christian ; Kaps, Manfred ; Tatlisumak, Turgut ; Putaala, Jukka ; Haeusler, Karl Georg ; Silva, Alexandre Décio Borges Do Amaral E ; Kinsella, Justin A. ; McCabe, Dominick J H ; Tobin, William ; Huber, Roman ; Willeit, Johann ; Furtner, Martin ; Bodechtel, Ulf ; Rolfs, Arndt ; Kessler, Christof ; Hennerici, Michael G. / Cervical artery dissection in young adults in the stroke in young fabry patients (sifap1) study. In: Cerebrovascular Diseases. 2015 ; Vol. 39, No. 2. pp. 110-121.
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abstract = "Background: Patients with carotid artery dissection (CAD) have been reported to have different vascular risk factor profiles and clinical outcomes to those with vertebral artery dissection (VAD). However, there are limited data from recent, large international studies comparing risk factors and clinical features in patients with cervical artery dissection (CeAD) with other TIA or ischemic stroke (IS) patients of similar age and sex. Methods: We analysed demographic, clinical and risk factor profiles in TIA and IS patients ≤55 years of age with and without CeAD in the large European, multi-centre, Stroke In young FAbry Patients 1 (sifap1) study. Patients were further categorised according to age (younger: 18-44 years; middle-aged: 45-55 years), sex, and site of dissection. Results: Data on the presence of dissection were available in 4,208 TIA and IS patients of whom 439 (10.4{\%}) had CeAD: 196 (50.1{\%}) had CAD, 195 (49.9{\%}) had VAD, and 48 had multiple artery dissections or no information regarding the dissected artery. The prevalence of CAD was higher in women than in men (5.9 vs. 3.8{\%}, p < 0.01), whereas the prevalence of VAD was similar in women and men (4.6 vs. 4.7{\%}, n.s.). Patients with VAD were younger than patients with CAD (median = 41 years (IQR = 35-47 years) versus median = 45 years (IQR = 39-49 years); p < 0.01). At stroke onset, about twice as many patients with either CAD (54.0 vs. 23.1{\%}, p < 0.001) or VAD (63.4 vs. 36.6{\%}, p < 0.001) had headache than patients without CeAD and stroke in the anterior or posterior circulation, respectively. Compared to patients without CeAD, hypertension, concomitant cardiovascular diseases and a patent foramen ovale were significantly less prevalent in both CAD and VAD patients, whereas tobacco smoking, physical inactivity, obesity and a family history of cerebrovascular diseases were found less frequently in CAD patients, but not in VAD patients. A history of migraine was observed at a similar frequency in patients with CAD (31{\%}), VAD (27.8{\%}) and in those without CeAD (25.8{\%}). Conclusions: We identified clinical features and risk factor profiles that are specific to young patients with CeAD, and to subgroups with either CAD or VAD compared to patients without CeAD. Therefore, our data support the concept that certain vascular risk factors differentially affect the risk of CAD and VAD.",
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TY - JOUR

T1 - Cervical artery dissection in young adults in the stroke in young fabry patients (sifap1) study

AU - Von Sarnowski, Bettina

AU - Schminke, Ulf

AU - Grittner, Ulrike

AU - Fazekas, Franz

AU - Tanislav, Christian

AU - Kaps, Manfred

AU - Tatlisumak, Turgut

AU - Putaala, Jukka

AU - Haeusler, Karl Georg

AU - Silva, Alexandre Décio Borges Do Amaral E

AU - Kinsella, Justin A.

AU - McCabe, Dominick J H

AU - Tobin, William

AU - Huber, Roman

AU - Willeit, Johann

AU - Furtner, Martin

AU - Bodechtel, Ulf

AU - Rolfs, Arndt

AU - Kessler, Christof

AU - Hennerici, Michael G.

PY - 2015/3/6

Y1 - 2015/3/6

N2 - Background: Patients with carotid artery dissection (CAD) have been reported to have different vascular risk factor profiles and clinical outcomes to those with vertebral artery dissection (VAD). However, there are limited data from recent, large international studies comparing risk factors and clinical features in patients with cervical artery dissection (CeAD) with other TIA or ischemic stroke (IS) patients of similar age and sex. Methods: We analysed demographic, clinical and risk factor profiles in TIA and IS patients ≤55 years of age with and without CeAD in the large European, multi-centre, Stroke In young FAbry Patients 1 (sifap1) study. Patients were further categorised according to age (younger: 18-44 years; middle-aged: 45-55 years), sex, and site of dissection. Results: Data on the presence of dissection were available in 4,208 TIA and IS patients of whom 439 (10.4%) had CeAD: 196 (50.1%) had CAD, 195 (49.9%) had VAD, and 48 had multiple artery dissections or no information regarding the dissected artery. The prevalence of CAD was higher in women than in men (5.9 vs. 3.8%, p < 0.01), whereas the prevalence of VAD was similar in women and men (4.6 vs. 4.7%, n.s.). Patients with VAD were younger than patients with CAD (median = 41 years (IQR = 35-47 years) versus median = 45 years (IQR = 39-49 years); p < 0.01). At stroke onset, about twice as many patients with either CAD (54.0 vs. 23.1%, p < 0.001) or VAD (63.4 vs. 36.6%, p < 0.001) had headache than patients without CeAD and stroke in the anterior or posterior circulation, respectively. Compared to patients without CeAD, hypertension, concomitant cardiovascular diseases and a patent foramen ovale were significantly less prevalent in both CAD and VAD patients, whereas tobacco smoking, physical inactivity, obesity and a family history of cerebrovascular diseases were found less frequently in CAD patients, but not in VAD patients. A history of migraine was observed at a similar frequency in patients with CAD (31%), VAD (27.8%) and in those without CeAD (25.8%). Conclusions: We identified clinical features and risk factor profiles that are specific to young patients with CeAD, and to subgroups with either CAD or VAD compared to patients without CeAD. Therefore, our data support the concept that certain vascular risk factors differentially affect the risk of CAD and VAD.

AB - Background: Patients with carotid artery dissection (CAD) have been reported to have different vascular risk factor profiles and clinical outcomes to those with vertebral artery dissection (VAD). However, there are limited data from recent, large international studies comparing risk factors and clinical features in patients with cervical artery dissection (CeAD) with other TIA or ischemic stroke (IS) patients of similar age and sex. Methods: We analysed demographic, clinical and risk factor profiles in TIA and IS patients ≤55 years of age with and without CeAD in the large European, multi-centre, Stroke In young FAbry Patients 1 (sifap1) study. Patients were further categorised according to age (younger: 18-44 years; middle-aged: 45-55 years), sex, and site of dissection. Results: Data on the presence of dissection were available in 4,208 TIA and IS patients of whom 439 (10.4%) had CeAD: 196 (50.1%) had CAD, 195 (49.9%) had VAD, and 48 had multiple artery dissections or no information regarding the dissected artery. The prevalence of CAD was higher in women than in men (5.9 vs. 3.8%, p < 0.01), whereas the prevalence of VAD was similar in women and men (4.6 vs. 4.7%, n.s.). Patients with VAD were younger than patients with CAD (median = 41 years (IQR = 35-47 years) versus median = 45 years (IQR = 39-49 years); p < 0.01). At stroke onset, about twice as many patients with either CAD (54.0 vs. 23.1%, p < 0.001) or VAD (63.4 vs. 36.6%, p < 0.001) had headache than patients without CeAD and stroke in the anterior or posterior circulation, respectively. Compared to patients without CeAD, hypertension, concomitant cardiovascular diseases and a patent foramen ovale were significantly less prevalent in both CAD and VAD patients, whereas tobacco smoking, physical inactivity, obesity and a family history of cerebrovascular diseases were found less frequently in CAD patients, but not in VAD patients. A history of migraine was observed at a similar frequency in patients with CAD (31%), VAD (27.8%) and in those without CeAD (25.8%). Conclusions: We identified clinical features and risk factor profiles that are specific to young patients with CeAD, and to subgroups with either CAD or VAD compared to patients without CeAD. Therefore, our data support the concept that certain vascular risk factors differentially affect the risk of CAD and VAD.

KW - Acute ischaemic stroke

KW - Carotid arteries

KW - Cerebral infarcts in young adults

KW - Cerebral ischaemia

KW - Dissection

KW - Risk factors for stroke

KW - Vertebral artery dissection

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