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01-09-2015 | Original Communication

Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS)

Authors: Barbara Goeggel Simonetti, Marie-Luise Mono, Uyen Huynh-Do, Patrik Michel, Celine Odier, Roman Sztajzel, Philippe Lyrer, Stefan T. Engelter, Leo Bonati, Henrik Gensicke, Christopher Traenka, Barbara Tettenborn, Bruno Weder, Urs Fischer, Aekaterini Galimanis, Simon Jung, Rudolf Luedi, Gian Marco De Marchis, Anja Weck, Carlo W. Cereda, Ralf Baumgartner, Claudio L. Bassetti, Heinrich P. Mattle, Krassen Nedeltchev, Marcel Arnold

Published in: Journal of Neurology | Issue 9/2015

Abstract

Ischaemic stroke (IS) in young adults has been increasingly recognized as a serious health condition. Stroke aetiology is different in young adults than in the older population. This study aimed to investigate aetiology and risk factors, and to search for predictors of outcome and recurrence in young IS patients. We conducted a prospective multicentre study of consecutive IS patients aged 16–55 years. Baseline demographic data, risk factors, stroke aetiology including systematic genetic screening for Fabry disease and severity were assessed and related to functional neurological outcome (modified Rankin Scale, mRS), case fatality, employment status, place of residence, and recurrent cerebrovascular events at 3 months. In 624 IS patients (60 % men), median age was 46 (IQR 39–51) years and median NIHSS on admission 3 (IQR 1–8). Modifiable vascular risk factors were found in 73 %. Stroke aetiology was mostly cardioembolism (32 %) and of other defined origin (24 %), including cervicocerebral artery dissection (17 %). Fabry disease was diagnosed in 2 patients (0.3 %). Aetiology remained unknown in 20 %. Outcome at 3 months was favourable (mRS 0–1) in 61 % and fatal in 2.9 %. Stroke severity (p < 0.001) and diabetes mellitus (p = 0.023) predicted unfavourable outcome. Stroke recurrence rate at 3 months was 2.7 %. Previous stroke or TIA predicted recurrent cerebrovascular events (p = 0.012). In conclusion, most young adults with IS had modifiable vascular risk factors, emphasizing the importance of prevention strategies. Outcome was unfavourable in more than a third of patients and was associated with initial stroke severity and diabetes mellitus. Previous cerebrovascular events predicted recurrent ones.

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Title: Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS)
Authors: Barbara Goeggel Simonetti
Marie-Luise Mono
Uyen Huynh-Do
Patrik Michel
Celine Odier
Roman Sztajzel
Philippe Lyrer
Stefan T. Engelter
Leo Bonati
Henrik Gensicke
Christopher Traenka
Barbara Tettenborn
Bruno Weder
Urs Fischer
Aekaterini Galimanis
Simon Jung
Rudolf Luedi
Gian Marco De Marchis
Anja Weck
Carlo W. Cereda
Ralf Baumgartner
Claudio L. Bassetti
Heinrich P. Mattle
Krassen Nedeltchev
Marcel Arnold
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 9/2015
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-015-7805-5

At a glance: The STEP trials

Springer Medicine

Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS)

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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