TY - JOUR
T1 - Prevalence of stenoses and occlusions of brain-supplying arteries in young stroke patients
AU - Von Sarnowski, Bettina
AU - Schminke, Ulf
AU - Tatlisumak, Turgut
AU - Putaala, Jukka
AU - Grittner, Ulrike
AU - Kaps, Manfred
AU - Tobin, William O.
AU - Kinsella, Justin A.
AU - McCabe, Dominick J.H.
AU - Hennerici, Michael G.
AU - Fazekas, Franz
AU - Norrving, Bo
AU - Kessler, Christof
AU - Rolfs, Arndt
PY - 2013/4/2
Y1 - 2013/4/2
N2 - Objective: Atherosclerosis is believed to be a minor cause of TIA and stroke in younger and middleaged patients. However, data from large cohorts are limited. This study investigates the prevalence of extracranial and intracranial atherosclerosis in stroke and TIA patients aged 18-55 years in the multinational sifap1 study. Methods: From the sifap1 cohort (n = 5,023), we analyzed a subset of patients with complete data from carotid ultrasound studies. Patients with arterial dissections, vasculitis, and mobile thrombi were excluded. Among the remaining 2,187 patients (men: n = 1,319; 18-44 years: n = 744), intracranial arteries were additionally examined with ultrasonography in 1,612 patients (73.7%). Patients were stratified by sex and age groups (younger: 18-44 years; middle-aged: 45-55 years). Results: In patients with ischemic stroke, the overall prevalence of carotid artery stenoses and occlusions was 8.9% (younger: 4.9%; middle-aged: 11.0%), of which 81% were symptomatic. Nonstenotic carotid plaques weremore common inmen than in women (15.8%vs 7.7%; p < 0.001), and in middle-aged than in younger patients (17.0% vs 4.9%; p < 0.001). Supratentorial intracranial artery stenoses and occlusions amounted to 11.8%. Supratentorial stenoses occurred more frequently in middle-aged patients (13.0% vs 7.8%; p , 0.001), whereas occlusions were equally common (both 3.2%; not significant). Conclusions: We observed a substantial proportion of atherosclerotic carotid artery stenoses and occlusions in younger stroke patients. Intracranial stenoses and occlusions were even more prevalent than extracranial carotid artery disease. Together with nonstenotic plaques, one-fifth of patients (21.2%) had symptomatic or asymptomatic large-artery atherosclerosis, which should encourage future stroke prevention campaigns to target risk factor modification in young people.
AB - Objective: Atherosclerosis is believed to be a minor cause of TIA and stroke in younger and middleaged patients. However, data from large cohorts are limited. This study investigates the prevalence of extracranial and intracranial atherosclerosis in stroke and TIA patients aged 18-55 years in the multinational sifap1 study. Methods: From the sifap1 cohort (n = 5,023), we analyzed a subset of patients with complete data from carotid ultrasound studies. Patients with arterial dissections, vasculitis, and mobile thrombi were excluded. Among the remaining 2,187 patients (men: n = 1,319; 18-44 years: n = 744), intracranial arteries were additionally examined with ultrasonography in 1,612 patients (73.7%). Patients were stratified by sex and age groups (younger: 18-44 years; middle-aged: 45-55 years). Results: In patients with ischemic stroke, the overall prevalence of carotid artery stenoses and occlusions was 8.9% (younger: 4.9%; middle-aged: 11.0%), of which 81% were symptomatic. Nonstenotic carotid plaques weremore common inmen than in women (15.8%vs 7.7%; p < 0.001), and in middle-aged than in younger patients (17.0% vs 4.9%; p < 0.001). Supratentorial intracranial artery stenoses and occlusions amounted to 11.8%. Supratentorial stenoses occurred more frequently in middle-aged patients (13.0% vs 7.8%; p , 0.001), whereas occlusions were equally common (both 3.2%; not significant). Conclusions: We observed a substantial proportion of atherosclerotic carotid artery stenoses and occlusions in younger stroke patients. Intracranial stenoses and occlusions were even more prevalent than extracranial carotid artery disease. Together with nonstenotic plaques, one-fifth of patients (21.2%) had symptomatic or asymptomatic large-artery atherosclerosis, which should encourage future stroke prevention campaigns to target risk factor modification in young people.
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UR - http://www.scopus.com/inward/citedby.url?scp=84876370717&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e31828ab2ed
DO - 10.1212/WNL.0b013e31828ab2ed
M3 - Article
C2 - 23468548
AN - SCOPUS:84876370717
SN - 0028-3878
VL - 80
SP - 1287
EP - 1294
JO - Neurology
JF - Neurology
IS - 14
ER -