%0 Journal Article
%T Strength of association of classical vascular risk factors in young patients with ischaemic stroke: a case-control study.
%A Ramírez-Moreno JM
%A Rebollo B
%A Macías-Sedas P
%A Valverde N
%A Parejo A
%A Felix-Redondo FJ
%A Roa Montero AM
%A Constantino AB
%A Gómez Baquero MJ
%A Ceberino-Muñoz D
%A Fernández-Bergés D
%J Neurologia (Engl Ed)
%V 0
%N 0
%D Oct 2022 26
%M 36309160
暂无%R 10.1016/j.nrleng.2022.07.006
%X <B>BACKGROUND: </B>Recent studies have reported an increasing incidence of ischaemic stroke among young adults. However, the strength of the association between traditional vascular risk factors has not been fully established.<BR><B>METHODS: </B>We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup.<BR><B>RESULTS: </B>Using logistic regression analysis, we found that overall, the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), atrial fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDL-C showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology.<BR><B>CONCLUSIONS: </B>Hypertension, auricular fibrillation, low eGFR, and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.