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. 2016 Sep 20;87(12):1212-9.
doi: 10.1212/WNL.0000000000003123. Epub 2016 Aug 12.

Accelerated development of cerebral small vessel disease in young stroke patients

Renate M Arntz  1 , Steffen M A van den Broek  1 , Inge W M van Uden  1 , Mohsen Ghafoorian  1 , Bram Platel  1 , Loes C A Rutten-Jacobs  1 , Noortje A M Maaijwee  1 , Pauline Schaapsmeerders  1 , Hennie C Schoonderwaldt  1 , Ewoud J van Dijk  1 , Frank-Erik de Leeuw  2
Affiliations

Accelerated development of cerebral small vessel disease in young stroke patients

Renate M Arntz et al. Neurology. .

Abstract

Objective: To study the long-term prevalence of small vessel disease after young stroke and to compare this to healthy controls.

Methods: This prospective cohort study comprises 337 patients with an ischemic stroke or TIA, aged 18-50 years, without a history of TIA or stroke. In addition, 90 age- and sex-matched controls were included. At follow-up, lacunes, microbleeds, and white matter hyperintensity (WMH) volume were assessed using MRI. To investigate the relation between risk factors and small vessel disease, logistic and linear regression were used.

Results: After mean follow-up of 9.9 (SD 8.1) years, 337 patients were included (227 with an ischemic stroke and 110 with a TIA). Mean age of patients was 49.8 years (SD 10.3) and 45.4% were men; for controls, mean age was 49.4 years (SD 11.9) and 45.6% were men. Compared with controls, patients more often had at least 1 lacune (24.0% vs 4.5%, p < 0.0001). In addition, they had a higher WMH volume (median 1.5 mL [interquartile range (IQR) 0.5-3.7] vs 0.4 mL [IQR 0.0-1.0], p < 0.001). Compared with controls, patients had the same volume WMHs on average 10-20 years earlier. In the patient group, age at stroke (β = 0.03, 95% confidence interval [CI] 0.02-0.04) hypertension (β = 0.22, 95% CI 0.04-0.39), and smoking (β = 0.18, 95% CI 0.01-0.34) at baseline were associated with WMH volume.

Conclusions: Patients with a young stroke have a higher burden of small vessel disease than controls adjusted for confounders. Cerebral aging seems accelerated by 10-20 years in these patients, which may suggest an increased vulnerability to vascular risk factors.

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Figures

Figure 1
Figure 1. Relation between age at follow-up and white matter hyperintensity (WMH) volume for patients and controls
Mean WMH volume stratified by age groups of 5 years.
See this image and copyright information in PMC

References

    1. Kissela BM, Khoury JC, Alwell K, et al. . Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology 2012;79:1781–1787. - PMC - PubMed
    1. Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P, van Dijk EJ, de Leeuw FE. Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol 2014;10:315–325. - PubMed
    1. O'Flaherty M, Ford E, Allender S, Scarborough P, Capewell S. Coronary heart disease trends in England and Wales from 1984 to 2004: concealed levelling of mortality rates among young adults. Heart 2008;94:178–181. - PubMed
    1. Bots ML, van Dis I, Koopman C, Vaartjes I, Visseren FJL. Hart- en Vaatziekten in Nederland 2013: Cijfers over leefstijl, risicofactoren, ziekte en sterfte. Den Haag: Nederlandse Hartstichting; 2013.
    1. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 2010;9:689–701. - PubMed

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