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- Putaala, Jukka, et al.
(author)
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Searching for Explanations for Cryptogenic Stroke in the Young : Revealing the Triggers, Causes, and Outcome (SECRETO): Rationale and design
- 2017
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In: European Stroke Journal. - : SAGE Publications. - 2396-9873 .- 2396-9881. ; 2:2, s. 116-125
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Journal article (peer-reviewed)abstract
- Background: Worldwide, about 1.3 million annual ischaemic strokes (IS) occur in adults aged <50 years. Of these early-onset strokes, up to 50% can be regarded as cryptogenic or associated with conditions with poorly documented causality like patent foramen ovale and coagulopathies. Key hypotheses/aims: (1) Investigate transient triggers and clinical/sub-clinical chronic risk factors associated with cryptogenic IS in the young; (2) use cardiac imaging methods exceeding state-of-the-art to reveal novel sources for embolism; (3) search for covert thrombosis and haemostasis abnormalities; (4) discover new disease pathways using next-generation sequencing and RNA gene expression studies; (5) determine patient prognosis by use of phenotypic and genetic data; and (6) adapt systems medicine approach to investigate complex risk-factor interactions. Design: Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) is a prospective multi-centre case–control study enrolling patients aged 18–49 years hospitalised due to first-ever imaging-proven IS of undetermined etiology. Patients are examined according to a standardised protocol and followed up for 10 years. Patients are 1:1 age- and sex-matched to stroke-free controls. Key study elements include centralised reading of echocardiography, electrocardiography, and neurovascular imaging, as well as blood samples for genetic, gene-expression, thrombosis and haemostasis and biomarker analysis. We aim to have 600 patient–control pairs enrolled by the end of 2018. Summary: SECRETO is aiming to establish novel mechanisms and prognosis of cryptogenic IS in the young and will provide new directions for therapy development for these patients. First results are anticipated in 2019.
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| 2. |
- Yesilot, Nilufer, et al.
(author)
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Ethnic and Geographical Differences in Ischaemic Stroke Among Young Adults.
- 2017
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In: Current vascular pharmacology. - : Bentham Science Publishers Ltd.. - 1875-6212 .- 1570-1611. ; 15:5, s. 416-429
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Journal article (peer-reviewed)abstract
- Ischaemic stroke in young adults encompasses approximately 5 - 15% of all ischaemic strokes, depending on the selected upper age limit. The key features of the disease, including incidence, risk factors, underlying causes, mortality, outcomes, as well as long-term risks of recurrent events are different from those for elderly patients. There is also evidence indicating that these characteristics may differ ethnically and geographically. It is clinically important to recognize such differences not only for correct diagnosis and treatment, but also for introducing accurate preventive measures. Ethnic differences may stem from several factors, including genetic influence, and necessitate different approaches, such as personalized diagnostic work-up based on patient characteristics.In this review, we summarize and discuss the existing data on the geographic and ethnic differential characteristics of young adult ischaemic stroke.
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