title: Admission markers predict lacunar and non-lacunar stroke in young patients.
abstract: Stroke in young adults is an important cause of lifelong morbidity. The aim of this study was to explore some possible admission indicator of subsequent lacunar or non-lacunar strokes. We enrolled 626 patients with the first young cerebral strokes and divided them into lacunar and non-lacunar stroke based on clinical presentation and neuroradiological findings; and the analyses were adjusted for the effects of potential confounders. Hypertension, hyperlipidemia, atrial fibrillation, cerebral vascular moyamoya malformation were significantly more frequent in non-lacunar patients than lacunar patients (respectively P=0.005, 0.048, 0.000, 0.015, 0.030). Serum BUN, Triglyceride, Cholesterol, HDL, UA, White cell count, Fibrinogen, INR and bilirubin (including Total bilirubin, Direct bilirubin, Indirect bilirubin) levels on admission were higher in non-lacunar strokes than in lacunar strokes. Serum white blood cell count (Odds Ratio 1.097; 95% Confidence Interval 1.006-1.195, P=0.035), lower high-density lipoprotein levels (defined as HDL<0.9 mmol/L) (Odds Ratio 1.884; 95% Confidence Interval 1.035-3.285, P=0.038) and serum total bilirubin (Odds Ratio 1.054; 95% Confidence Interval 1.019-1.091, P=0.003) were associated with increased risk for non-lacunar stroke, whereas lacunar stroke was related to age at onset (Odds Ratio 0.929; 95% Confidence Interval 0.888-0.972, P=0.001) and SUA (Odds Ratio 0.997; 95% Confidence Interval 0.995-0.999, P=0.015). The excess risks were blood WBC, lower HDL and total bilirubin levels for non-lacunar strokes, and serum UA and age at onset for lacunar strokes in young Chinese patients.
authors.affiliation: Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience and The Second Affiliated Hospital of GuangZhou Medical University, 250# Changgang east Road, GuangZhou, 510260 Guangdong Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: WeiZhi
authors.initials: W
authors.lastname: Zhang
authors.forename: Xi
authors.initials: X
authors.lastname: Li
authors.forename: ShuXiang
authors.initials: S
authors.lastname: Pu
authors.forename: JianRui
authors.initials: J
authors.lastname: Yin
authors.forename: Ning
authors.initials: N
authors.lastname: Yang
authors.forename: YongHong
authors.initials: Y
authors.lastname: Yi
authors.forename: QingChun
authors.initials: Q
authors.lastname: Gao
authors.forename: Cong
authors.initials: C
authors.lastname: Gao
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000145:classification / Q000209:etiology; D055815:Young Adult
chemical_list: D015415:Biomarkers