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Acute Cerebrovascular Disease in the Young The Stroke in Young Fabry Patients Study

Rolfs, Arndt; Fazekas, Franz; Grittner, Ulrike; Dichgans, Martin; Martus, Peter; Holzhausen, Martin; Boettcher, Tobias; Heuschmann, Peter U.; Tatlisumak, Turgut and Tanislav, Christian, et al. (2013) In Stroke: a journal of cerebral circulation 44(2). p.340-349
Abstract
Background and Purpose-Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. Methods-Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers... (More)
Background and Purpose-Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. Methods-Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers between April 2007 and January 2010 undergoing a detailed, standardized, clinical, laboratory, and radiological protocol. Results-Median age in the overall cohort was 46 years. Definite Fabry disease was diagnosed in 0.5% (95% confidence interval, 0.4%-0.8%; n=27) of all patients; and probable Fabry disease in additional 18 patients. Males dominated the study population (2962/59%) whereas females outnumbered men (65.3%) among the youngest patients (18-24 years). About 80.5% of the patients had a first stroke. Silent infarcts on magnetic resonance imaging were seen in 20% of patients with a first-ever stroke, and in 11.4% of patients with transient ischemic attack and no history of a previous cerebrovascular event. The most common causes of ischemic stroke were large artery atherosclerosis (18.6%) and dissection (9.9%). Conclusions-Definite Fabry disease occurs in 0.5% and probable Fabry disease in further 0.4% of young stroke patients. Silent infarcts, white matter intensities, and classical risk factors were highly prevalent, emphasizing the need for new early preventive strategies. (Less)
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Contribution to journal
publication status
published
subject
keywords
cause, Fabry disease, imaging, intracerebral hemorrhage, ischemic, stroke, risk factors, transient ischemic attack, young stroke
in
Stroke: a journal of cerebral circulation
volume
44
issue
2
pages
340 - 349
publisher
American Heart Association
external identifiers
  • wos:000313754800019
  • scopus:84872956926
ISSN
1524-4628
DOI
10.1161/STROKEAHA.112.663708
language
English
LU publication?
yes
id
d3911363-f00e-49b7-a97a-9c2b5b021838 (old id 3591180)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23306324
date added to LUP
2013-03-20 14:20:46
date last changed
2019-09-15 04:06:11
@article{d3911363-f00e-49b7-a97a-9c2b5b021838,
  abstract     = {Background and Purpose-Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. Methods-Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers between April 2007 and January 2010 undergoing a detailed, standardized, clinical, laboratory, and radiological protocol. Results-Median age in the overall cohort was 46 years. Definite Fabry disease was diagnosed in 0.5% (95% confidence interval, 0.4%-0.8%; n=27) of all patients; and probable Fabry disease in additional 18 patients. Males dominated the study population (2962/59%) whereas females outnumbered men (65.3%) among the youngest patients (18-24 years). About 80.5% of the patients had a first stroke. Silent infarcts on magnetic resonance imaging were seen in 20% of patients with a first-ever stroke, and in 11.4% of patients with transient ischemic attack and no history of a previous cerebrovascular event. The most common causes of ischemic stroke were large artery atherosclerosis (18.6%) and dissection (9.9%). Conclusions-Definite Fabry disease occurs in 0.5% and probable Fabry disease in further 0.4% of young stroke patients. Silent infarcts, white matter intensities, and classical risk factors were highly prevalent, emphasizing the need for new early preventive strategies.},
  author       = {Rolfs, Arndt and Fazekas, Franz and Grittner, Ulrike and Dichgans, Martin and Martus, Peter and Holzhausen, Martin and Boettcher, Tobias and Heuschmann, Peter U. and Tatlisumak, Turgut and Tanislav, Christian and Jungehulsing, Gerhard J. and Giese, Anne-Katrin and Putaala, Jukaa and Huber, Roman and Bodechtel, Ulf and Lichy, Christoph and Enzinger, Christian and Schmidt, Reinhold and Hennerici, Michael G. and Kaps, Manfred and Kessler, Christof and Lackner, Karl and Paschke, Eduard and Meyer, Wolfgang and Mascher, Hermann and Riess, Olaf and Kolodny, Edwin and Norrving, Bo},
  issn         = {1524-4628},
  keyword      = {cause,Fabry disease,imaging,intracerebral hemorrhage,ischemic,stroke,risk factors,transient ischemic attack,young stroke},
  language     = {eng},
  number       = {2},
  pages        = {340--349},
  publisher    = {American Heart Association},
  series       = { Stroke: a journal of cerebral circulation},
  title        = {Acute Cerebrovascular Disease in the Young The Stroke in Young Fabry Patients Study},
  url          = {http://dx.doi.org/10.1161/STROKEAHA.112.663708},
  volume       = {44},
  year         = {2013},
}