Study on the incidence and risk factor of silent cerebrovascular disease in young adults with first-ever stroke

Abstract

Silent cerebrovascular diseases, including silent brain infarcts (SBI), white matter hyperintensity (WMH), and cerebral microbleed, are closely correlated with stroke progression. The purpose of this study was to investigate the prevalence and potential risk factors of SBI and WMH in young patients with first-ever stroke.A total of 400 young patients with first-ever stroke were included in this study and received magnetic resonance imaging test. The distributions of stroke subtypes were analyzed based on patients' age and gender. The prevalence of SBI and WMH was evaluated in different age groups and stroke subtypes. Independent risk factors for SBI and WMH were identified using logistic regression analysis.The distribution of stroke subtypes was not correlated with patients' age or gender in our study. The incidence of SBI and WMH among all of the young stroke patients was 14.50% and 8.75%, respectively, which showed an upward tendency with age. The percentages of both SBI and WMH were significantly higher in small-vessel disease patients than in cases with other subtype diseases (all P < .05). Hypertension (odds ratio [OR] = 2.645, 95% confidence interval [CI] = 1.429-4.896, P = .002 for SBI; OR = 5.474, 95% CI = 2.319-12.921, P = .000 for WMH; OR = 39.988, 95% CI = 3.988-400.949, P = .002 for SBI and WMH) and homocysteine (OR = 4.033, 95% CI = 2.191-7.425, P = .000 for SBI; OR = 5.989, 95% CI = 2.637-13.602, P = .000 for WMH; OR = 4.068, 95% CI = 1.207-13.715, P = .024 for SBI and WMH) might be potential risk factors for SBI and WMH.The prevalence of silent cerebrovascular disease was elevated with age. Hypertension and elevated homocysteine levels were 2 risk factors for silent cerebrovascular disease in young stroke patients.

Figure 1

The distribution of stroke subtypes stratified by patients’ age.

Figure 2

The frequency of stroke subtypes in males and females. The frequency of stroke subtypes in males was similar to that in females (P = .198).

Figure 3

Incidence of silent cerebrovascular disease (SBI and WMH) in different age groups of young stroke patient cohort (n = 400). Total incidence rate of SBI and WMH was increased with age. SBI = silent brain infarcts, WMH = white matter hyperintensity.

Figure 4

Prevalence of SBI and WMH in different stroke subtypes. SBI and WMH were more frequent in SVD patients. CE = cardioembolism, LAA = large-artery atherosclerosis, SBI = silent brain infarcts, SVD = small-vessel disease, WMH = white matter hyperintensity. ^∗P < .05.