Familial aggregation of stroke amongst young patients in Lund Stroke Register.
OBJECTIVE
The known monogenic forms of stroke are rare. The aim of this study was to analyze pedigrees of young stroke patients regarding possible monogenic cerebrovascular disease and to evaluate the possibility of genetic stroke in these families. This may contribute to a better understanding of disease mechanism in stroke.


METHODS
Lund Stroke Register includes consecutive patients with first-ever stroke from a defined geographical area in southern Sweden. Early-onset (≤55 years) stroke patients were systematically screened with regard to family history (FHx), and families with stroke aggregation were compiled. Participants provided information in a questionnaire on occurrence of stroke or transient ischaemic attack (TIA) in their families. Information on cardiovascular risk factors (VRFs) and clinical stroke subtype was collected. FHx for stroke was considered positive when the patient reported either ≥1 first-degree relative with stroke/TIA, or no first-degree relative but ≥3 second- or third-degree relatives with stroke/TIA in a distribution compatible with monogenic inheritance.


RESULTS
Of 4103 stroke patients registered, 426 (10%) had first-ever stroke at ≤55 years and 338 (79%) of these answered the questionnaire. Of them, 159 (47%) reported a positive FHx. Twenty-eight (18%) of the probands with positive FHx had no known VRFs. Thirty-two families with ≥4 members with stroke were identified. In all these larger families the affected individuals with stroke were present in more than one generation.


CONCLUSIONS
Aggregation of stroke in families of early-onset stroke patients is not uncommon. Genetic factors with impact on stroke risk, including monogenic causes, need to be evaluated in future stroke studies.
Lund University, Department of Clinical Sciences Lund, Neurology, Lund, Sweden.|Department of Internal Medicine, Landskrona Hospital, Landskrona, Sweden.
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A
Ilinca
Department of Clinical Genetics, Lund University and Regional Laboratories, Region Skåne, Sweden.
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U
Kristoffersson
Department of Clinical Genetics, Lund University and Regional Laboratories, Region Skåne, Sweden.
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M
Soller
Lund University, Department of Clinical Sciences Lund, Neurology, Lund, Sweden.|Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
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Lindgren
D000328:Adult; D017668:Age of Onset; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology
cerebral infarct; familial; risk factors; stroke; stroke in young adults