Tobacco Use and Cryptogenic Stroke in Young Adults.
OBJECTIVE
Cryptogenic stroke is the leading subtype of ischemic stroke in the young. We sought to evaluate the association between traditional cardiovascular risk factors and cryptogenic stroke by using a case-control study.


METHODS
Patients aged 18-54 years, consecutively treated for first-ever cryptogenic ischemic stroke in an academic stroke unit, were compared with subjects from the general population living in the same geographic area. Control subjects were matched for age and sex with patients. We further evaluated the association between significant risk factors and nonobstructive (<50% stenosis) carotid plaque and thrombus among patients with cryptogenic stroke. Odds ratios [OR] were calculated using logistic regression analysis.


RESULTS
A total of 155 patients with cryptogenic stroke (66.4% men, mean age 43.5 years [SD 8.4]) were included in the study. Cryptogenic stroke was associated with current tobacco use (42.6% in patients versus 23.9% in control subjects; OR = 2.38, 95% confidence interval [CI] 1.40-4.05, P = .002). Current tobacco use was associated with nonobstructive carotid plaque (OR = 6.22; 95% CI, 2.43-15.9; P = .001) and nonobstructive carotid thrombus (OR = 13.7; 95% CI, 1.42-132.7; P = .03) among the patients.


CONCLUSIONS
Our case-control study showed a strong link between current tobacco use and cryptogenic stroke in young adults.
Department of Neurology, Toulouse University Hospital, 31059 Toulouse Cedex 9, France. Electronic address: jaffre.a@chu-toulouse.fr.
Aude
A
Jaffre
Department of Epidemiology and INSERM U1027, Toulouse University Hospital, 31059 Toulouse Cedex 9, France.
Jean Bernard
JB
Ruidavets
Department of Neurology, Toulouse University Hospital, 31059 Toulouse Cedex 9, France.
Nathalie
N
Nasr
Department of Neurology, Toulouse University Hospital, 31059 Toulouse Cedex 9, France.
Brigitte
B
Guidolin
Department of Epidemiology and INSERM U1027, Toulouse University Hospital, 31059 Toulouse Cedex 9, France.
Jean
J
Ferrieres
Department of Neurology, Toulouse University Hospital, 31059 Toulouse Cedex 9, France.
Vincent
V
Larrue
D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications*; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*; D064424:Tobacco Use / Q000009:adverse effects*; D055815:Young Adult
Stroke; cryptogenic; ischemic stroke; tobacco use; young