Eltemamy Marwa Ahmed, Tamayo Arturo, Altarsha Eyad, Sedghi Annahita, Pallesen Lars-Peder, Barlinn Jessica, Puetz Volker, Illigens Ben Min-Woo, Barlinn Kristian, Siepmann Timo
Department of Stroke Medicine, Fairfield General Hospital, Manchester, United Kingdom.
Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany.
Front Neurol. 2021 Nov 12;12:736818. doi: 10.3389/fneur.2021.736818. eCollection 2021.
The constantly increasing incidence of stroke in younger individuals substantiates an urgent need for research to elucidate underlying risk factors and etiologies. Heretofore, the vast majority of studies on stroke in the young have been carried out in European and North American regions. We aimed to characterize cerebrovascular risk profiles in a Saudi Arabic cohort of consecutive young stroke patients. We retrospectively analyzed data from consecutive ischemic stroke patients aged 15 to 49 years who underwent detailed cardiocerebrovascular evaluation at a tertiary stroke care center in Makkah, Saudi Arabia. Distributions of risk factors and stroke etiologies were assessed in the entire cohort and in two strata of very young (15-40 years) and young to middle-aged patients (41-49) to account for variability in suggested age cutoffs. In the entire cohort [ = 63, ages 44 (34-47) median, interquartile range], dyslipidemia (71.4%) and small vessel occlusion (31.7%) displayed highest prevalence followed by diabetes (52.4%) and cardioembolism (19%). In very young patients, cardioembolism was the most prevalent etiology (27.3%). Risk profiles were similar between both age strata except for a higher prevalence of diabetes among the older cohort (31.8 vs. 63.4%, = 0.01). Logistic regression identified diabetes as strongest predictor for association to the older strata (odds ratio = 4.2, 95% confidence interval = 1.2-14.1, = 0.02). Cerebrovascular risk profiles and stroke etiologies in our cohort of young stroke patients differ from those of previous cohorts, suggesting the need for tailored prevention strategies that take into account local epidemiological data on cerebrovascular health.
年轻人中风发病率持续上升,这凸显了迫切需要开展研究以阐明潜在风险因素和病因。迄今为止,绝大多数关于青年中风的研究是在欧洲和北美地区进行的。我们旨在描述沙特阿拉伯一组连续的年轻中风患者的脑血管风险特征。我们回顾性分析了在沙特阿拉伯麦加的一家三级中风护理中心接受详细心脑血管评估的15至49岁连续缺血性中风患者的数据。在整个队列以及非常年轻(15 - 40岁)和年轻至中年患者(41 - 49岁)这两个分层中评估风险因素和中风病因的分布,以考虑建议年龄界限的变异性。在整个队列中(n = 63,年龄中位数44岁(34 - 47岁),四分位间距),血脂异常(71.4%)和小血管闭塞(31.7%)的患病率最高,其次是糖尿病(52.4%)和心源性栓塞(19%)。在非常年轻的患者中,心源性栓塞是最常见的病因(27.3%)。除了老年队列中糖尿病患病率较高(31.8%对63.4%,p = 0.01)外,两个年龄分层的风险特征相似。逻辑回归确定糖尿病是与老年分层关联的最强预测因素(比值比 = 4.2,95%置信区间 = 1.2 - 14.1,p = 0.02)。我们这组年轻中风患者的脑血管风险特征和中风病因与先前队列不同,这表明需要制定考虑到当地脑血管健康流行病学数据的针对性预防策略。