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Young ischaemic stroke incidence and demographic characteristics - The Norwegian stroke in the young study - A three-generation research program.

ABSTRACT: Introduction:Norwegian Stroke in the Young Study (NOR-SYS) is a three-generation research program of young ischaemic stroke. In this study, we assessed ischaemic stroke incidence, education and work status among young stroke patients. Furthermore, we evaluated the participation of family members for future validated information on hereditary cardiovascular events. Patients and methods:Patients aged 15-60 years with radiologically verified acute ischaemic stroke, admitted to Haukeland University Hospital in Bergen, Norway from 2010 to 2015, were included. Patients' partners, common offspring ? 18 years and biological parents of patients and partners were invited to participate. Ischaemic stroke incidence was analysed with respect to year, age and sex using multiple logistic regression. Results:A total of 385 patients, 260 partners (80.0%) and 414 offspring (74.6%) were clinically examined. The mean annual ischaemic stroke incidence rate was 30.2 per 100,000. Incidence was higher in men, and the difference was accentuated with increasing age (p?=?0.008). There was no sex difference in educational status (p?=?0.104) in contrast to work status (p?

SUBMITTER: Nawaz B

PROVIDER: S-EPMC6921944 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Young ischaemic stroke incidence and demographic characteristics - The Norwegian stroke in the young study - A three-generation research program.

Nawaz Beenish B Eide Geir E GE Fromm Annette A Øygarden Halvor H Sand Kristin M KM Thomassen Lars L Næss Halvor H Waje-Andreassen Ulrike U

European stroke journal 20190716 4

<h4>Introduction</h4>Norwegian Stroke in the Young Study (NOR-SYS) is a three-generation research program of young ischaemic stroke. In this study, we assessed ischaemic stroke incidence, education and work status among young stroke patients. Furthermore, we evaluated the participation of family members for future validated information on hereditary cardiovascular events.<h4>Patients and methods</h4>Patients aged 15-60 years with radiologically verified acute ischaemic stroke, admitted to Haukel ...[more]

PMID: 31903433

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Project description:Ultrasound accelerates thrombolysis with tPA (sonothrombolysis). Ultrasound in the absence of tPA also accelerates clot break-up (sonolysis). Adding intravenous gaseous microbubbles may potentiate the effect of ultrasound in both sonothrombolysis and sonolysis. The Norwegian Sonothrombolysis in Acute Stroke Study aims in a pragmatic approach to assess the effect and safety of contrast enhanced ultrasound treatment in unselected acute ischaemic stroke patients.Acute ischaemic stroke patients ? 18 years, with or without visible arterial occlusion on computed tomography angiography (CTA) and treatable ? 4(½) hours after symptom onset, are included in NOR-SASS. NOR-SASS is superimposed on a separate trial randomising patients with acute ischemic stroke to either tenecteplase or alteplase (The Norwegian Tenecteplase Stroke Trial NOR-TEST). The NOR-SASS trial has two arms: 1) the thrombolysis-arms (NOR-SASS A and B) includes patients given intravenous thrombolysis (tenecteplase or alteplase), and 2) the no-thrombolysis-arm (NOR-SASS C) includes patients with contraindications to thrombolysis. First step randomisation of NOR-SASS A is embedded in NOR-TEST as a 1:1 randomisation to either tenecteplase or alteplase. Second step NOR-SASS randomisation is 1:1 to either contrast enhanced sonothrombolysis (CEST) or sham CEST. Randomisation in NOR-SASS B (routine alteplase group) is 1:1 to either CEST or sham CEST. Randomisation of NOR-SASS C is 1:1 to either contrast enhanced sonolysis (CES) or sham CES. Ultrasound is given for one hour using a 2-MHz pulsed-wave diagnostic ultrasound probe. Microbubble contrast (SonoVue®) is given as a continuous infusion for ~30 min. Recanalisation is assessed at 60 min after start of CEST/CES. Magnetic resonance imaging and angiography is performed after 24 h of stroke onset. Primary study endpoints are 1) major neurological improvement measured with NIHSS score at 24 h and 2) favourable functional outcome defined as mRS 0-1 at 90 days.NOR-SASS is the first randomised controlled trial designed to test the superiority of contrast enhanced ultrasound treatment given ? 4(½)?hours after stroke onset in an unselected acute ischaemic stroke population eligible or not eligible for intravenous thrombolysis, with or without a defined arterial occlusion on CTA. If a positive effect and safety can be proven, contrast enhanced ultrasound treatment will be an option for all acute ischaemic stroke patients. EudraCT No 201200032341; www.clinicaltrials.gov NCT01949961.

Project description:BackgroundFamily history (FH) is a risk factor for cardiovascular disease, especially coronary artery disease (CAD). The impact on risk of stroke is less clear. This study investigated young and middle-aged ischemic stroke patients' knowledge on FH of stroke, CAD, and peripheral artery disease (PAD) with a special regard to sex differences.MethodsFrom September 2010 to February 2014, all ischemic stroke patients aged 15-60 years were prospectively included in the Norwegian Stroke in the Young Study (NOR-SYS). FH of stroke, CAD and PAD in offspring, siblings, parents, and grandparents was assessed using a standardized face-to-face interview. In addition to 'yes' and 'no', the optional reply 'don't know' was included to improve accuracy. McNemar's test was used to compare paired proportions, i.e. FH in male vs. female relatives. Multiple logistic regression analyses were used to test the influence of patient sex on FH reporting and to adjust for possible confounding factors.ResultsAltogether 257 patients were included. Mean age was 49.5 years and 68.1% were males. FH of cardiovascular disease was reported by 59% of patients. When asked about FH of stroke, 48 (18.7%) and 46 (17.9%) patients reported yes, whereas 17 (6.6%) and 9 (3.5%) reported 'don't know' regarding father and mother respectively, similarly patients reported 'don't know' regarding 117 (45.5%) paternal vs. 83 (32.4%) maternal grandmothers (p < 0.001). Female patients reported less 'don't know' and were more likely to report a positive cardiovascular FH than males (OR: 3.4; 95% CI: 1.5 to 7.7; p = 0.004). Patients had more detailed knowledge about CAD than stroke in fathers (p < 0.001), mothers (p < 0.001) and siblings (p = 0.01).ConclusionsYoung and middle-aged stroke patients reported a high FH burden of cardiovascular disease. Females are more likely to report a positive FH than males. Detailed knowledge on FH was best for CAD. Our results suggest sex has a big impact on FH knowledge. Females have more knowledge of FH than males and knowledge is better for relatives with a female than male linkage.Clinical trial registrationhttp://www.clinicaltrials.gov , unique identifier: NCT01597453 .

Dataset Information

Young ischaemic stroke incidence and demographic characteristics - The Norwegian stroke in the young study - A three-generation research program.

Publications

Young ischaemic stroke incidence and demographic characteristics - The Norwegian stroke in the young study - A three-generation research program.

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