title: Risk factor profile by etiological subtype of ischemic stroke in the young.
abstract: OBJECTIVE
  Studies of risk factors for ischemic stroke in the young have generally considered ischemic stroke as a whole. The purpose of the present study was to evaluate the association of traditional cardiovascular risk factors with etiological subtypes of ischemic stroke in young adults.
  
  
  METHODS
  Retrospective review of data from patients aged 16-54 years consecutively treated for first-ever ischemic stroke in an academic stroke unit. Definite causes of stroke were classified using the ASCO (A for atherothrombosis, S for small vessel disease, C for cardiac source, O for other cause) classification system. We used multinomial logistic regression analysis to evaluate associations of age, gender, smoking, hypertension, diabetes and blood lipids with each etiological subtype.
  
  
  RESULTS
  A total of 400 patients were included: 244 men (61.1%), 156 women (38.9%); mean age (SD) 44.5 (8.5) years. A definite cause of stroke could be identified in 202 (50.5%) patients. Definite causes of stroke included: atherothrombosis, 72 (18.0%) patients; cardioembolism, 37 (9.25%) patients; small vessel disease, 28 (7.0%) patients; other definite cause, 65 (16.25%) patients including 44 patients with carotid or vertebral artery dissection. Atherothrombosis was associated with age, smoking, diabetes, hypertension and low HDL-cholesterol. Small vessel disease was associated with age and hypertension. Cardioembolism was associated with age.
  
  
  CONCLUSIONS
  The risk factor profile differs between etiological subtypes of ischemic stroke in young adults. Our findings emphasize the impact of smoking, diabetes, hypertension and low HDL-cholesterol as risk factors for atherothrombosis, and of hypertension as a risk factor for small vessel disease in young adults.
authors.affiliation: Department of Neurology, CHU Toulouse Rangueil, 31059 Toulouse, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Jaffre
authors.affiliation: Department of Epidemiology and INSERM U558, CHU Toulouse Purpan, 31059 Toulouse, France.
authors.forename: Jean Bernard
authors.initials: JB
authors.lastname: Ruidavets
authors.affiliation: Department of Neurology, CHU Toulouse Rangueil, 31059 Toulouse, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Calviere
authors.affiliation: Department of Neurology, CHU Toulouse Rangueil, 31059 Toulouse, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Viguier
authors.affiliation: Department of Epidemiology and INSERM U558, CHU Toulouse Purpan, 31059 Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrieres
authors.affiliation: Department of Neurology, CHU Toulouse Rangueil, 31059 Toulouse, France. Electronic address: larrue.v@chu-toulouse.fr.
authors.forename: Vincent
authors.initials: V
authors.lastname: Larrue
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002545:Brain Ischemia / Q000145:classification* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000145:classification* / Q000209:etiology*; D055815:Young Adult
keywords: Epidemiology; Etiology; Ischemic stroke; Risk factor; Stroke; Young