Stroke in first-degree relatives of patients with cervical artery dissection.
OBJECTIVE
Patients with ischaemic stroke (IS) caused by a spontaneous cervical artery dissection (CeAD) worry about an increased risk for stroke in their families. The occurrence of stroke in relatives of patients with CeAD and in those with ischaemic stroke attributable to other (non-CeAD) causes were compared.


METHODS
The frequency of stroke in first-degree relatives (family history of stroke, FHS) was studied in IS patients (CeAD patients and age- and sex-matched non-CeAD patients) from the Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) database. FHS ≤ 50 and FHS > 50 were defined as having relatives who suffered stroke at the age of ≤50 or >50 years. FHS ≤ 50 and FHS > 50 were studied in CeAD and non-CeAD IS patients and related to age, sex, number of siblings, hypertension, hypercholesterolemia, smoking and body mass index (BMI).


RESULTS
In all, 1225 patients were analyzed. FHS ≤ 50 was less frequent in CeAD patients (15/598 = 2.5%) than in non-CeAD IS patients (38/627 = 6.1%) (P = 0.003; odds ratio 0.40, 95% confidence interval 0.22-0.73), also after adjustment for age, sex and number of siblings (P = 0.005; odds ratio 0.42, 95% confidence interval 0.23-0.77). The frequency of FHS > 50 was similar in both study groups. Vascular risk factors did not differ between patients with positive or negative FHS ≤ 50. However, patients with FHS > 50 were more likely to have hypertension and higher BMI.


CONCLUSIONS
Relatives of CeAD patients had fewer strokes at a young age than relatives of non-CeAD IS stroke patients.
Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.|Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
M
M
Kloss
Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
C
C
Grond-Ginsbach
Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy.
A
A
Pezzini
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
T M
http://orcid.org/0000-0003-3425-0094
TM
Metso
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
A J
AJ
Metso
Department of Neurology, Hôpital Lariboisière, Paris, France.|Department of Neurology, University Lille Nord de France, Lille, France.|Department of Epidemiology and Public Health, INSERM U744, Pasteur Institute, Lille, France.
S
S
Debette
Department of Neurology, University Lille Nord de France, Lille, France.
D
D
Leys
Department of Epidemiology and Public Health, INSERM U744, Pasteur Institute, Lille, France.
J
J
Dallongeville
Stroke Unit, Perugia University Hospital, Perugia, Italy.
V
V
Caso
Department of Neurosciences, VIB - Vesalius Research Center, Experimental Neurology - Laboratory of Neurobiology, KU Leuven - University of Leuven, Leuven, Belgium.|Neurology, University Hospitals Leuven, Leuven, Belgium.
V
V
Thijs
Cerebrovascular Unit, IRCCS Foundation C. Besta Neurological Institute, Milan, Italy.
A
A
Bersano
Department of Neurology, University of Caen Basse Normandie, INSERM U919, CHU Côte de Nacre, Caen, France.
E
E
Touzé
Department of Neurology, Basel University Hospital, Basel, Switzerland.
L H
LH
Bonati
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
T
T
Tatlisumak
Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
M-L
ML
Arnold
Department of Neurology, Basel University Hospital, Basel, Switzerland.
P A
PA
Lyrer
Department of Neurology, Basel University Hospital, Basel, Switzerland.|Neurorehabilitation Unit, University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Basel, Switzerland.
S T
ST
Engelter
D000328:Adult; D002545:Brain Ischemia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D020217:Vertebral Artery Dissection / Q000453:epidemiology*
cervical artery dissection (CeAD); family history of stroke (FHS); young stroke