Risk Factors for Early-Onset Ischemic Stroke: A Case-Control Study
Risk Factors for Early-Onset Ischemic Stroke: A Case-Control Study
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DOI：
10.1161/jaha.118.009774
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发表时间：
2018-11-06
影响因子：
5.4
通讯作者：
Putaala, Jukka
中科院分区：
文献类型：
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作者：
Kivioja, Reetta;Pietila, Arto;Putaala, Jukka
背景-最近的研究表明，年轻人缺血性卒中（IS）中血管危险因素的患病率增加。然而，所有的血管危险因素和早发性IS之间的关联强度尚未完全established.Methods和Results-We比较了961例首次IS在25至49岁的1403频率匹配的无卒中对照人群为基础的队列研究（FINRISK）。评估的风险因素包括活动性恶性肿瘤、房颤、心血管疾病、当前吸烟状况、卒中家族史、高低密度脂蛋白胆固醇、高甘油三酯、低高密度脂蛋白胆固醇、高血压、1型和2型糖尿病。我们根据年龄、性别和IS病因进行了亚组分析。在一个完全校正的多变量逻辑回归分析中，IS的重要危险因素包括房颤（比值比[OR]，10.43; 95%置信区间[CI]，2.33-46.77），心血管疾病（OR，8.01; 95% CI，3.09-20.78），1型糖尿病（OR，6.72; 95%CI，3.15-14.33），2型糖尿病（OR，2.31; 95% CI，1.35-3.95），低高密度脂蛋白胆固醇（OR，1.81; 95%CI，1.37-2.40），当前吸烟状况（OR，1.81; 95%CI，1.50-2.17）、高血压（OR，1.43; 95%CI，1.17-1.75）和卒中家族史（OR，1.37; 95%CI，1.04-1.82）。高低密度脂蛋白胆固醇与IS呈负相关。在亚组分析中，最一致的协会出现目前的吸烟状况和1型diabetesmellitus.Conclusions-Our研究建立了11个血管危险因素和早发性IS之间的关联，其中房颤，心血管疾病，1型和2型糖尿病，特别是表现出很强的关联。
Background-Recent studies have shown an increasing prevalence of vascular risk factors in young adults with ischemic stroke (IS). However, the strength of the association between all vascular risk factors and early-onset IS has not been fully established.Methods and Results-We compared 961 patients with a first-ever IS at 25 to 49 years to 1403 frequency-matched stroke-free controls from a population-based cohort study (FINRISK). Assessed risk factors included an active malignancy, atrial fibrillation, cardiovascular disease, current smoking status, a family history of stroke, high low-density lipoprotein cholesterol, high triglycerides, low high-density lipoprotein cholesterol, hypertension, and type 1 and type 2 diabetes mellitus. We performed subgroup analyses based on age, sex, and IS etiology. In a fully adjusted multivariable logistic regression analysis, significant risk factors for IS consisted of atrial fibrillation (odds ratio [OR], 10.43; 95% confidence interval [CI], 2.33-46.77], cardiovascular disease (OR, 8.01; 95% CI, 3.09-20.78), type 1 diabetes mellitus (OR, 6.72; 95% CI, 3.15-14.33), type 2 diabetes mellitus (OR, 2.31; 95% CI, 1.35-3.95), low high-density lipoprotein cholesterol (OR, 1.81; 95% CI, 1.37-2.40), current smoking status (OR, 1.81; 95% CI, 1.50-2.17), hypertension (OR, 1.43; 95% CI, 1.17-1.75), and a family history of stroke (OR, 1.37; 95% CI, 1.04-1.82). High low-density lipoprotein cholesterol exhibited an inverse association with IS. In the subgroup analyses, the most consistent associations appeared for current smoking status and type 1 diabetes mellitus.Conclusions-Our study establishes the associations between 11 vascular risk factors and early-onset IS, among which atrial fibrillation, cardiovascular disease, and both type 1 and 2 diabetes mellitus in particular showed strong associations.