title: Determinants of premature familial arterial thrombosis in patients with juvenile ischaemic stroke. The Italian Project on Stroke in Young Adults (IPSYS).
abstract: Factors predicting family history (FH) of premature arterial thrombosis in young patients with ischaemic stroke (IS) have not been extensively investigated, and whether they might influence the risk of post-stroke recurrence is still unknown. In the present study we analysed 1,881 consecutive first-ever IS patients aged 18-45 years recruited from January 2000 to January 2012 as part of the Italian Project on Stroke in Young Adults (IPSYS). FH of premature arterial thrombosis was any thrombotic event [IS, myocardial infarction or other arterial events event] < 45 years in proband's first-degree relatives. Compared with patients without FH of premature arterial thrombosis, those with FH (n = 85) were more often smokers (odds ratio [OR], 1.94; 95 % confidence interval [CI], 1.21-3.09) and carriers of procoagulant abnormalities (OR, 3.66; 95 % CI, 2.21-6.06). Smoking (OR, 2.48; 95 % CI, 1.20-5.15), the A1691 mutation in factor V gene (OR, 3.64; 95 % CI, 1.31-10.10), and the A20210 mutation in the prothrombin gene (OR, 8.40; 95 % CI 3.35-21.05) were associated with FH of premature stroke (n = 33), while circulating anti-phospholipids to FH of premature myocardial infarction (n = 45; OR, 3.48; 95 % CI, 1.61-7.51). Mean follow-up time was 46.6 ± 38.6 months. Recurrent events occurred more frequently in the subgroup of patients with FH of premature stroke [19.4 %); p = 0.051] compared to patients without such a FH. In conclusion, young IS patients with FH of premature arterial thrombosis exhibit a distinct risk-factor profile, an underlying procoagulant state and have worse vascular prognosis than those with no FH of juvenile thrombotic events.
authors.affiliation: Alessandro Pezzini, Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italia, Tel: +39.030.3384086, Fax: +39.030. 3384086, E-mail: ale_pezzini@hotmail.com, alessandro.pezzini@unibs.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pezzini
authors.forename: Mario
authors.initials: M
authors.lastname: Grassi
authors.forename: Corrado
authors.initials: C
authors.lastname: Lodigiani
authors.forename: Rosalba
authors.initials: R
authors.lastname: Patella
authors.forename: Carlo
authors.initials: C
authors.lastname: Gandolfo
authors.forename: Andrea
authors.initials: A
authors.lastname: Zini
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: DeLodovici
authors.forename: Maurizio
authors.initials: M
authors.lastname: Paciaroni
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Sette
authors.forename: Antonella
authors.initials: A
authors.lastname: Toriello
authors.forename: Rossella
authors.initials: R
authors.lastname: Musolino
authors.forename: Rocco Salvatore
authors.initials: RS
authors.lastname: Calabrò
authors.forename: Paolo
authors.initials: P
authors.lastname: Bovi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Adami
authors.forename: Giorgio
authors.initials: G
authors.lastname: Silvestrelli
authors.forename: Maria
authors.initials: M
authors.lastname: Sessa
authors.forename: Anna
authors.initials: A
authors.lastname: Cavallini
authors.forename: Simona
authors.initials: S
authors.lastname: Marcheselli
authors.forename: Domenico Marco
authors.initials: DM
authors.lastname: Bonifati
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Checcarelli
authors.forename: Lucia
authors.initials: L
authors.lastname: Tancredi
authors.forename: Alberto
authors.initials: A
authors.lastname: Chiti
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Del Zotto
authors.forename: Alessandra
authors.initials: A
authors.lastname: Spalloni
authors.forename: Paolo
authors.initials: P
authors.lastname: Costa
authors.forename: Giacomo
authors.initials: G
authors.lastname: Giacalone
authors.forename: Paola
authors.initials: P
authors.lastname: Ferrazzi
authors.forename: Loris
authors.initials: L
authors.lastname: Poli
authors.forename: Andrea
authors.initials: A
authors.lastname: Morotti
authors.forename: Maurizia
authors.initials: M
authors.lastname: Rasura
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Simone
authors.forename: Massimo
authors.initials: M
authors.lastname: Gamba
authors.forename: Paolo
authors.initials: P
authors.lastname: Cerrato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Micieli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Melis
authors.forename: Davide
authors.initials: D
authors.lastname: Massucco
authors.forename: Valeria
authors.initials: V
authors.lastname: De Giuli
authors.forename: Daniele
authors.initials: D
authors.lastname: Pepe
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D017152:Antibodies, Antiphospholipid / Q000097:blood; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000235:genetics; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D016009:Chi-Square Distribution; D005165:Factor V / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D040941:Heredity; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D016017:Odds Ratio; D010641:Phenotype; D011379:Prognosis; D016016:Proportional Hazards Models; D011516:Prothrombin / Q000235:genetics; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D013927:Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D013997:Time Factors; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid; D015415:Biomarkers; D005165:Factor V; D011516:Prothrombin
keywords: Stroke in young adults; cohort studies; risk factors in epidemiology