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Main risk factors and characteristics of ischemic strokes in young men (according to Yaroslavl Region data)

Abstract

Cerebrovascular diseases are the second leading cause of death worldwide. The results of various studies showed a high percentage of young adults among stroke patients. Men have a higher risk of stroke most of their life. Men and women with ischemic stroke differ in risk factors for stroke. The etiology of stroke is also different in men and women. In the course of the work a pro- and retrospective analysis of 90 case histories of young age men with ischemic stroke treated at the vascular department of Yaroslavl city (Russia) in 2013-2015 years was done. Among the patients studied, the average age at the time of ischemic stroke was 38.9 ± 4.9 years. In the sample, there were recorded as primary (n = 63; 70 %) and repeated (n = 27; 30 %) strokes. According to the TOAST criteria with full and in-depth examination of these patients atherothrombotic subtype (46.7 %), lacunar subtype (25.6 %), cardioembolic subtype (4.5 %), ischemic stroke of other known etiology (5.6 %) and unspecified subtype (17.6 %) revealed. As important risk factors among the patients of young age were smoking (especially in combination with hypercholesterolaemia), presence of hypertension, obesity (increased BMI). They make the greatest contribution to the development of atherosclerotic lesions of the carotid arteries in men up to 45 years.

About the Authors

N. A. Pizov
Yaroslavl State Mesical University
Russian Federation


N. V. Pizova
Yaroslavl State Mesical University
Russian Federation


References

1. WHO. The Top 10 Causes of Death. World Health Organization: Geneva, Switzerland; 2011. The 10 leading causes of death by broad income group, 2008.

2. WHO. The World Health Report 2002 - Reducing Risks, Promoting Healthy Life. World Health Organization: Geneva, Switzeland; 2002. Educ. Health (Abingdon). 2003; 16 (2): 230.

3. Roger V.L., Go A.S., Lloyd-Jones D.M. et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2011 update: a report from the American Heart Association. Circulation. 2011; 123 (4): e18-e209.

4. Gall S.L., Tran P.L., Martin K. et al. Sex differences in long-term outcomes after stroke: functional outcomes, handicap, and quality of life. Stroke. 2012; 43 (7): 1982-7.

5. Manolio T.A., Kronmal R.A., Burke G.L. et al. Short-term predictors of incident stroke in older adults. The Cardiovascular Health Study. Stroke. 1996; 27: 1479-1486.

6. Kleindorfer D., Broderick J., Khoury J. et al. The unchanging incidence and case-fatali-ty of stroke in the 1990s: a population-based study. Stroke. 2006; 37 (10): 2473-2478.

7. Putaala J., Metso A.J., Metso T.M. et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke. 2009; 40 (4): 1195-203

8. González-Gómez F.J., Pérez-Torre P., DeFelipe A. et al. Stroke in young adults: Incidence rate, risk factors, treatment and prognosis. Rev. Clin. Esp. 2016 Jun 10. pii: S 0014-2565(16)30081-9. doi: 10.1016/j.rce.2016.05.008.

9. Rosamond W., Flegal K., Furie K. et al. Heart disease and stroke statistics - 2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008; 117: e25-146.

10. Turtzo L.C., McCullough L.D. Sex-specific responses to stroke. Future Neurol. 2010; 5: 47-59.

11. Jousilahti P., Vartiainen E., Tuomilehto J. et al. Sex, age, cardiovascular risk factors, and coronary heart disease: a prospective follow-up study of 14786 middle-aged men and women in Finland. Circulation 1999; 99: 1465-72.

12. Armstrong-Wells J., Johnston S.C., Wu Y.W. et al. Prevalence and predictors of perinatal hemorrhagic stroke: results from the Kaiser Pediatric Stroke Study. Pediatrics. 2009; 123 (3): 823-8.

13. Bonduel M., Sciuccati G., Hepner M. et al. Arterial ischemic stroke and cerebral venous thrombosis in children: a 12-year Argentinean registry. Acta Haematol. 2006; 115 (3-4): 180-185.

14. Golomb M.R., Dick P.T., MacGregor D.L. et al. Neonatal arterial ischemic stroke and cerebral sinovenous thrombosis are more commonly diagnosed in boys. J. Child Neurol. 2004; 19 (7): 493-497.

15. Golomb M.R., Fullerton H.J., Nowak-Gottl U., Deveber G.; International Pediatric Stroke Study Group.Male predominance in childhood ischemic stroke: findings from the international pediatric stroke study. Stroke. 2009; 40 (1): 52-7.

16. Raju T.N., Nelson K.B., Ferriero D., Lynch J.K. Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. Pediatrics. 2007; 120 (3): 609-616.

17. Salih M.A., Abdel-Gader A.G., Al-Jarallah A.A. et al. Stroke in Saudi children. Epidemiology, clinical features and risk factors. Saudi. Med. J. 2006; 27 (1): 12-20.

18. Di Carlo A., Lamassa M., Baldereschi M. et al. European BIOMED Study of Stroke Care Group. Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital-based registry. Stroke. 2003; 34: 1114-19.

19. Holroyd-Leduc J.M., Kapral M.K., Austin P.C., Tu J.V. Sex differences and similarities in the management and outcome of stroke patients. Stroke. 2000; 31: 1833-37.

20. Kapral M.K., Fang J., Hill M.D. et al. Investigators of the Registry of the Canadian Stroke Network. Sex differences in stroke care and outcomes: results from the Registry of the Canadian Stroke Network. Stroke. 2005; 36: 809-14.

21. Niewada M., Kobayashi A., Sandercock P.A. et al. International Stroke Trial Collaborative Group. Influence of gender on baseline features and clinical outcomes among 17,370 patients with confirmed ischaemic stroke in the international stroke trial. Neuroepidemiology. 2005; 24: 123-28.

22. Roquer J., Campello A.R., Gomis M. Sex differences in first-ever acute stroke. Stroke. 2003; 34: 1581-85.

23. Arboix A., Oliveres M., Garcia-Eroles L. et al. Acute cerebrovascular disease in women. Eur. Neurol. 2001; 45: 199-205.

24. Gray L.J., Sprigg N., Bath P.M. et al. TAIST Investigators. Sex differences in quality of life in stroke survivors: data from the tinzaparin in Acute Ischaemic Stroke Trial (TAIST) Stroke. 2007; 38: 2960-64.

25. Kolominsky-Rabas P.L., Weber M., Gefeller O. et al. Epidemiology of ischemic stroke subtypes according to TOAST criteria - incidence, recurrence, and long-term survival in ischemic stroke subtypes: a population-based study. Stroke. 2001; 32: 2735-40.

26. Group SCotPHSR. Final report on the aspirin component of the ongoing physicians' health study. Steering Committee of the Physicians' Health Study Research Group. N. Engl. J. Med. 1989; 321 (3): 129-135.

27. Ridker P.M., Cook N.R., Lee I.M. et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N. Engl. J. Med. 2005; 352 (13): 1293-1304.

28. Berger J. S., Roncaglioni M. C., Avanzini F. et al. Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA. 2006; 295 (3): 306-313.

29. Zuern C.S., Lindemann S., Gawaz M. Platelet function and response to aspirin: gender-specific features and implications for female thrombotic risk and management. Semin. Thromb. Hemost. 2009; 35 (3): 295-306.

30. Gray-Weale A.C., Graham J.C., Burnett J.R. et al. Carotid artery atheroma: comparison of preoperative B-mode ultrasound appearance with carotid endarterectomy specimen pathology. J. Cardiovasc. Surg. 1988; 29 (6): 676-81.

31. Haapaniemi H., Hillbom M., Juvela S. Lifestyle-associated risk factors for acute brain infarction among persons of working age. Stroke. 1997; 28: 26-30.

32. Kittner S.J., McCarter R.J., Sherwin R.W. et al. Black-white differences in stroke risk among young adults. Stroke. 1993; 24 (1): I-13-5.

33. Kittner S.J., Stern B.J., Wozniak M. et al. Cerebral infarction in young adults: the Baltimore-Washington Cooperative Young Stroke Study. Neurology. 1998; 50: 890-4.

34. Appelros P., Stegmayr B., Terent A. Sex differences in stroke epidemiology: a systematic review. Stroke. 2009; 40 (4): 1082-90.

35. Adams H.P., Bendixen B.H., Kappelle L.J. et al. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. Stroke. 1993; 24 (1): 35-41.

36. Kwon S.U., Kim J.S., Lee J.H., Lee M.C. Ischemic stroke in Korean young adults. Acta Neurol. Scand. 2000; 101: 19-24.

37. Lee T.H., Hsu W.C., Chen C.J., Chen ST. Etiologic study of young ischemic stroke in Taiwan. Stroke. 2002; 33: 1950-5.

38. Nedeltchev K., der Maur T.A., Georgiadis D. et al. Ischaemic stroke in young adults: predictors of outcome and recurrence. J. Neurol. Neurosurg. Psychiatry. 2005; 76: 191-5.

39. Förster A., Gass A., Kern R. et al. Gender differences in acute ischemic stroke: etiology, stroke patterns and response to thrombolysis. Stroke. 2009; 40 (7): 2428-32.

40. Galassi A., Reynolds K., He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am. J. Med. 2006; 119: 812-19.

41. Kannel W.B., McGee D.L. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979; 241:.2035-38.

42. Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking. A preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA 1990; 264 (23): 3018-24.

43. Wissler R.W., Vesselinovitch D. An update on the pathogenesis of atherosclerosis (principles of prevention, intervention, retardation, and regression). Hawaii Med. J. 1990; 49 (7): 237-40.

44. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. European Carotid Surgery Trial-ists' Collaborative Group. Lancet 1991; 337 (8752): 1235-43.

45. Volkow N.D., Mullani N., Gould K.L. et al. Cerebral blood flow in chronic cocaine users: a study with positron emission tomography. Br. J. Psychiatry. 1988; 152: 641-8.

46. Кузьмина Л.П., Тарасов А.А., Хайбулина А.З. Клинико-биохимические изменения при воздействии производственных стресс-факторов у шахтеров-угольщиков. Медицина труда и промышленная экология 2001; (8): 42-5.

47. Friedewald W.T., Levy R.I., Fredrickson D.S. Estimation of the concentration of low-density lipoproteins of plasma, without use of the preparative ultracentrifuge. Clin. Chem. 1972; 18 (6): 499-502.

48. McGill H.C. Jr., McMahan C.A., Malcom G.T. et al. Effects of serum lipoproteins and smoking on atherosclerosis in young men and women. The PDAY Research Group. Pathobiological Determinants of Atherosclerosis in Youth. Arterioscler. Thromb. Vasc. Biol. 1997; 17 (1): 95-106.

49. Persson J., Stavenow L., Wikstrand J. et al. Noninvasive quantification of atherosclerotic lesions. Reproducibility of ultrasonographic measurement of arterial wall thickness and plaque size. Arterioscler. Tromb. 1992; 12 (2): 261-6.

50. Strong J.P. Natural history and risk factors for early human atherogenesis. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Clin. Chem. 1995; 41 (1): 134-8.

51. Пизова Н.В. Заболевания сердца и инсульты у лиц молодого возраста. Неврология, нейропсихиатрия, психосоматика 2014; 2: 62-69.

52. Пизов Н.А., Пизова Н.В. Роль липопротеина (а) в развитии ишемического инсульта и других сердечно-сосудистых заболеваний. Неврология, нейропсихиатрия, психосоматика. 2016; 8 (1): 90-95.

53. Пизова Н.В. Острые нарушения мозгового кровообращения у лиц с недифференцированноыми дисплазиями соединительной ткани в молодом возраста. Невроньюс 2015; 6 (9): 5-9.

54. Пизова Н.В., Дружинин Д.С. Атеросклеротическое поражение сонных артерий у пациентов молодого возраста. Клиницист. 2014; 1: 28-34.

55. Пизова Н.В. Наследственные тромбофилии и инсульт. Журн. неврологии и психиатрии им. С.С. Корсакова, 2013: 8 (113): 76-81.


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Pizov N.A., Pizova N.V. Main risk factors and characteristics of ischemic strokes in young men (according to Yaroslavl Region data). Medical alphabet. 2017;1(2):28-32. (In Russ.)

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