Risk factors for cryptogenic ischaemic stroke.
This case-control study was designed to identify risk factors for cryptogenic brain infarction. We assessed the frequency of prothrombotic states, homocysteine, lipoprotein (a) [Lp(a)] and other lipids and the apolipoprotein E phenotype together with conventional risk factors in 46 patients (19 women and 27 men) with cryptogenic brain infarction aged from 15 to 60 years and in 104 community-based controls. Multivariate odds ratios (ORs) for risk factors and 95% CIs were calculated by logistic regression. Hypertension (OR 4.5; 95% CI, 1.5-13.2; P = 0.006), current smoking (OR 2.9; 95% CI, 1.2-6.8; P = 0.012), low HDL cholesterol (HDL-C) (OR 5.4; 95% CI, 1.1-25.5; P = 0.035) and high clotting factor VIII activity (OR 3.6; 95% CI, 1.1-12.2; P = 0.041) were variables associated with cryptogenic brain infarction. These risk factors were not equally frequent in women and men. Low HDL-C and high factor VIII activity in the women, and hypertension, current smoking and a low level of plasma folate in the men were risk factors for cryptogenic stroke. Several of the observed risk factors for cryptogenic brain infarction were lifestyle-associated, which emphasizes the role of health education in addition to pharmacological treatment in the prevention of stroke.
Karttunen
V
V
Department of Neurology, Oulu University Central Hospital, Helsinki, Finland. vesa.karttunen@oulu.fi
Alfthan
G
G
Hiltunen
L
L
Rasi
V
V
Kervinen
K
K
Kesäniemi
Y A
YA
Hillbom
M
M
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005492:Folic Acid / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000209:etiology*
D008076:Cholesterol, HDL; D005169:Factor VIII; D005492:Folic Acid