Jood Katarina, Ladenvall Claes, Rosengren Annika, Blomstrand Christian, Jern Christina
Institute of Clinical Neuroscience, Sahlgrenska Academy, Göteborg University, Sweden.
Stroke. 2005 Jul;36(7):1383-7. doi: 10.1161/01.STR.0000169944.46025.09. Epub 2005 Jun 2.
Results from twin and family history studies of ischemic stroke suggest that future molecular genetic studies should focus on strictly defined stroke subtypes and younger cases. Accordingly, we investigated stroke subtypes, vascular risk factors, and family history in a large study of patients with ischemic stroke onset before age 70 years.
Six hundred consecutive white participants with ischemic stroke (18 to 69 years) and 600 age- and sex-matched controls were examined for vascular risk factors and family history of stroke and myocardial infarction (MI). Stroke subtype was defined using Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.
Family history of stroke was associated with overall ischemic stroke (multivariate odds ratio [OR], 1.75; 95% confidence interval [CI], 1.26 to 2.43), large-vessel disease (LVD) (OR, 1.88; 95% CI, 1.02 to 3.44), small-vessel disease (SVD, OR, 1.79; 95% CI, 1.13 to 2.84), and cryptogenic stroke (OR, 1.70; 95% CI, 1.13 to 2.56), but not with cardioembolic stroke. Family history of MI was strongly associated with LVD (OR, 3.25; 95% CI, 1.74 to 6.07), whereas no significant association were observed for other subtypes. We also found an independent association between family history of stroke and a favorable outcome after 3 months.
Family history of stroke is an independent risk factor for ischemic stroke with onset before age 70 years. For the first time to our knowledge, we report this association not only for LVD and SVD but also for cryptogenic stroke, implying that future studies of the genetics of ischemic stroke should target these 3 subtypes.
缺血性中风的双胞胎及家族史研究结果表明，未来的分子遗传学研究应聚焦于严格定义的中风亚型及较年轻的病例。因此，我们在一项针对70岁之前发病的缺血性中风患者的大型研究中，调查了中风亚型、血管危险因素及家族史。
对600名连续入选的缺血性中风白人患者（年龄在18至69岁之间）以及600名年龄和性别匹配的对照者进行了血管危险因素以及中风和心肌梗死（MI）家族史的检查。中风亚型采用急性中风治疗中组织纤溶酶原激活剂-10172试验（TOAST）标准进行定义。
中风家族史与总体缺血性中风（多变量比值比[OR]，1.75；95%置信区间[CI]，1.26至2.43）、大血管疾病（LVD）（OR，1.88；95%CI，1.02至3.44）、小血管疾病（SVD，OR，1.79；95%CI，1.13至2.84）和隐源性中风（OR，1.70；95%CI，1.13至2.56）相关，但与心源性栓塞性中风无关。心肌梗死家族史与LVD密切相关（OR，3.25；95%CI，1.74至6.07），而在其他亚型中未观察到显著关联。我们还发现中风家族史与3个月后的良好预后之间存在独立关联。
中风家族史是70岁之前发病的缺血性中风的独立危险因素。据我们所知，我们首次报告了这种关联不仅存在于LVD和SVD，也存在于隐源性中风，这意味着未来缺血性中风遗传学研究应针对这三种亚型。
