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Family history of stroke and cardiovascular diseases in early-onset cryptogenic ischaemic stroke




TekijätSihvo, Maximilian C.; Ylikotila, Pauli; Zedde, Marialuisa; Pascarella, Rosario; Sarkanen, Tomi; Jatuzis, Dalius; Ryliskiene, Kristina; Von Sarnowski, Bettina; Licenik, Radim; Ferdinand, Phillip; Korv, Janika; Korv, Liisa; Pezzini, Alessandro; Fonseca, Ana Catarina; Paula, Andre; Martinez-Sanchez, Patricia; Yesilot, Nilufer; Fromm, Annette; Waje-Andreassen, Ulrike; Redfors, Petra; Jood, Katarina; Huhtakangas, Juha; Sairanen, Tiina; Hedman, Marja; Jakala, Pekka; Ten Cate, Hugo; Gerdts, Eva; Lehto, Mika; Sinisalo, Juha; Kittner, Steven J.; Mitchell, Braxton D.; Lindgren, Arne G.; Ilinca, Andreea; Putaala, Jukka; Tomppo, Liisa; the SECRETO Study Group

KustantajaOxford University Press (OUP)

Julkaisuvuosi2026

Lehti: European Stroke Journal

Artikkelin numeroaakag013

Vuosikerta11

Numero3

ISSN2396-9873

eISSN2396-9881

DOIhttps://doi.org/10.1093/esj/aakag013

Julkaisun avoimuus kirjaamishetkelläAvoimesti saatavilla

Julkaisukanavan avoimuus Kokonaan avoin julkaisukanava

Verkko-osoitehttps://doi.org/10.1093/esj/aakag013

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/516034735

Rinnakkaistallenteen lisenssiCC BY

Rinnakkaistallennetun julkaisun versioKustantajan versio


Tiivistelmä

Background

Familial aggregation of stroke is well-documented, yet few studies have examined associations between stroke subtypes—particularly early-onset cryptogenic ischaemic stroke (eCIS)—and broader family history (FH) of cardiovascular disease. Such associations may provide insights into underlying etiologic mechanisms.

Methods

In this multicentre case–control study, we included eCIS patients aged 18–49 years and matched stroke-free controls. We analysed the association between FH of stroke, venous thromboembolism (VTE), coronary artery disease (CAD), aneurysms and eCIS using multivariable logistic regression, with a subgroup analysis stratifying patients by high-risk patent foramen ovale (HR-PFO).

Results

We enrolled 508 eCIS patients (182 [36%] with HR-PFO) and 520 controls. Compared with controls, patients more frequently reported FH of stroke among first-degree relatives (FDR) (20% vs. 14%, P = .01) and grandparents (47% vs. 39%, P = .01), FH of early-onset stroke among FDR (5% vs. 2%, P = .01) and FH of early-onset VTE among FDR (5% vs. 2%, P = .003). In adjusted analyses, eCIS was associated with FH of stroke among FDR (OR 1.50; 95% CI, 1.04–2.16) and grandparents (1.50; 1.12–1.99), with FH of early-onset stroke among FDR (2.36; 1.11–5.04); and with FH of early-onset VTE among FDR (3.45; 1.47–8.13). eCIS was also associated with FH of VTE among FDR (1.80, 1.09–2.98) in the presence of HR-PFO. FH of CAD or aneurysms was not associated with eCIS.

Conclusion

FH of stroke and VTE, particularly early-onset events and in the presence of HR-PFO, are associated with eCIS. These findings support familial predisposition and highlight prothrombotic mechanisms in eCIS.

Clinical trial registration

www.clinicaltrials.gov/study/NCT01934725


Ladattava julkaisu

This is an electronic reprint of the original article.
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Julkaisussa olevat rahoitustiedot
The study is funded by the Helsinki and Uusimaa Hospital District research fund (TYH2014407 and TYH2018318); the Academy of Finland (286246, 318075, and 322656); Sahlgrenska University Hospital (ALFGBG-726821), the Finnish Medical Foundation, and the Sigrid Juselius Foundation. Open access funded by Helsinki University Library.


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