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Article Dans Une Revue Circulation Année : 2011

Association of vascular risk factors with cervical artery dissection and ischemic stroke in young adults.

Tiina Metso
  • Fonction : Auteur
Alessandro Pezzini
  • Fonction : Auteur
Shérine Abboud
  • Fonction : Auteur
Antti Metso
  • Fonction : Auteur
Didier Leys
  • Fonction : Auteur
Anna Bersano
  • Fonction : Auteur
Fabien Louillet
  • Fonction : Auteur
Valeria Caso
  • Fonction : Auteur
Chantal Lamy
Elisabeth Medeiros
  • Fonction : Auteur
Caspar Grond-Ginsbach
  • Fonction : Auteur
Stefan T Engelter
  • Fonction : Auteur
Vincent Thijs
  • Fonction : Auteur
Simone Beretta
  • Fonction : Auteur
Maria Sessa
  • Fonction : Auteur
Maria Lorenza Muiesan
  • Fonction : Auteur
Maurizio Castellano
  • Fonction : Auteur
Turgut Tatlisumak
  • Fonction : Auteur
Non Renseigné
  • Fonction : Auteur

Résumé

BACKGROUND: Little is known about the risk factors for cervical artery dissection (CEAD), a major cause of ischemic stroke (IS) in young adults. Hypertension, diabetes mellitus, smoking, hypercholesterolemia, and obesity are important risk factors for IS. However, their specific role in CEAD is poorly investigated. Our aim was to compare the prevalence of vascular risk factors in CEAD patients versus referents and patients who suffered an IS of a cause other than CEAD (non-CEAD IS) in the multicenter Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) study. METHODS AND RESULTS: The study sample comprised 690 CEAD patients (mean age, 44.2 ± 9.9 years; 43.9% women), 556 patients with a non-CEAD IS (44.7 ± 10.5 years; 39.9% women), and 1170 referents (45.9 ± 8.1 years; 44.1% women). We compared the prevalence of hypertension, diabetes mellitus, hypercholesterolemia, smoking, and obesity (body mass index ≥ 30 kg/m²) or overweightness (body mass index ≥ 25 kg/m² and <30 kg/m²) between the 3 groups using a multinomial logistic regression adjusted for country of inclusion, age, and gender. Compared with referents, CEAD patients had a lower prevalence of hypercholesterolemia (odds ratio 0.55; 95% confidence interval, 0.42 to 0.71; P<0.0001), obesity (odds ratio 0.37; 95% confidence interval, 0.26 to 0.52; P<0.0001), and overweightness (odds ratio 0.70; 95% confidence interval, 0.57 to 0.88; P=0.002) but were more frequently hypertensive (odds ratio 1.67; 95% confidence interval, 1.32 to 2.1; P<0.0001). All vascular risk factors were less frequent in CEAD patients compared with young patients with a non-CEAD IS. The latter were more frequently hypertensive, diabetic, and current smokers compared with referents. CONCLUSION: These results, from the largest series to date, suggest that hypertension, although less prevalent than in patients with a non-CEAD IS, could be a risk factor of CEAD, whereas hypercholesterolemia, obesity, and overweightness are inversely associated with CEAD.

Dates et versions

hal-00795721 , version 1 (28-02-2013)

Identifiants

Citer

Stéphanie Debette, Tiina Metso, Alessandro Pezzini, Shérine Abboud, Antti Metso, et al.. Association of vascular risk factors with cervical artery dissection and ischemic stroke in young adults.. Circulation, 2011, 123 (14), pp.1537-1544. ⟨10.1161/CIRCULATIONAHA.110.000125⟩. ⟨hal-00795721⟩
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