Details

Autor(en) / Beteiligte

• Pezzini, Alessandro
• Grassi, Mario
• Lodigiani, Corrado
• Patella, Rosalba
• Gandolfo, Carlo
• Zini, Andrea
• DeLodovici, Maria Luisa
• Paciaroni, Maurizio
• Del Sette, Massimo
• Toriello, Antonella
• Musolino, Rossella
• Calabrò, Rocco Salvatore
• Bovi, Paolo
• Adami, Alessandro
• Silvestrelli, Giorgio
• Sessa, Maria
• Cavallini, Anna
• Marcheselli, Simona
• Bonifati, Domenico Marco
• Checcarelli, Nicoletta
• Tancredi, Lucia
• Chiti, Alberto
• Del Zotto, Elisabetta
• Spalloni, Alessandra
• Giossi, Alessia
• Volonghi, Irene
• Costa, Paolo
• Giacalone, Giacomo
• Ferrazzi, Paola
• Poli, Loris
• Morotti, Andrea
• Rasura, Maurizia
• Simone, Anna Maria
• Gamba, Massimo
• Cerrato, Paolo
• Micieli, Giuseppe
• Melis, Maurizio
• Massucco, Davide
• De Giuli, Valeria
• Iacoviello, Licia
• Padovani, Alessandro

Titel

Predictors of Long-Term Recurrent Vascular Events After Ischemic Stroke at Young Age: The Italian Project on Stroke in Young Adults

Ist Teil von

• Circulation (New York, N.Y.), 2014-04, Vol.129 (16), p.1668-1676

Ort / Verlag

Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUND—Data on long-term risk and predictors of recurrent thrombotic events after ischemic stroke at a young age are limited. METHODS AND RESULTS—We followed 1867 patients with first-ever ischemic stroke who were 18 to 45 years of age (mean age, 36.8±7.1 years; women, 49.0%), as part of the Italian Project on Stroke in Young Adults (IPSYS). Median follow-up was 40 months (25th to 75th percentile, 53). The primary end point was a composite of ischemic stroke, transient ischemic attack, myocardial infarction, or other arterial events. One hundred sixty-three patients had recurrent thrombotic events (average rate, 2.26 per 100 person-years at risk). At 10 years, cumulative risk was 14.7% (95% confidence interval, 12.2%–17.9%) for primary end point, 14.0% (95% confidence interval, 11.4%–17.1%) for brain ischemia, and 0.7% (95% confidence interval, 0.4%–1.3%) for myocardial infarction or other arterial events. Familial history of stroke, migraine with aura, circulating antiphospholipid antibodies, discontinuation of antiplatelet and antihypertensive medications, and any increase of 1 traditional vascular risk factor were independent predictors of the composite end point in multivariable Cox proportional hazards analysis. A point-scoring system for each variable was generated by their β-coefficients, and a predictive score (IPSYS score) was calculated as the sum of the weighted scores. The area under the receiver operating characteristic curve of the 0- to 5-year score was 0.66 (95% confidence interval, 0.61–0.71; mean, 10-fold internally cross-validated area under the receiver operating characteristic curve, 0.65). CONCLUSIONS—Among patients with ischemic stroke aged 18 to 45 years, the long-term risk of recurrent thrombotic events is associated with modifiable, age-specific risk factors. The IPSYS score may serve as a simple tool for risk estimation.