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Family history of stroke in stroke types and subtypes
P Polychronopoulos1, G Gioldasis, J Ellul
1Department of Neurology, University Hospital of Patras, P.O. Box 1045, 26500, Rion-, Patras, Greece.
Insights
A family history of stroke (FHS) is a significant independent risk factor for stroke. This study confirms FHS is linked to various stroke types, particularly large and small artery disease strokes.
Area of Science:
- Neurology
- Epidemiology
- Genetics
Background:
- Family history of stroke (FHS) is a known risk factor for stroke.
- The association between FHS and specific stroke subtypes requires further investigation.
Purpose of the Study:
- To evaluate the association between FHS and major stroke types (cerebral hematomas, ischemic strokes) and their subtypes in a Greek population.
Main Methods:
- A case-control study involving 421 acute stroke patients and 239 matched controls.
- Family history of stroke was collected and analyzed for associations with stroke types and subtypes.
Main Results:
- Positive FHS was found in 49% of stroke patients versus 28% of controls (adjusted OR=2.06).
- FHS was strongly associated with cerebral hematomas, ischemic strokes, large artery disease strokes, and small artery disease strokes.
- No significant difference was observed in heritable contribution between maternal and paternal sides.
Conclusions:
- Family history of stroke is an independent risk factor for overall stroke incidence.
- FHS is significantly associated with cerebral hematomas, ischemic strokes, and specifically large and small artery disease subtypes.
- FHS was not found to be a significant risk factor for cardioembolic or undetermined stroke subtypes.
Abstract:
Many studies have provided data showing that family history of stroke (FHS) is associated with an increased risk of stroke. The association of the FHS with the various stroke subtypes has not been adequately studied. The purpose of this study was to assess the association of the FHS with the two major stroke types (cerebral haematomas and ischaemic strokes) and the four stroke subtypes (cardioembolic, large artery disease, small artery disease, and undetermined) in a Greek population. The FHS was obtained from 421 consecutive acute stroke patients and from 239 matched control subjects. Positive FHS was observed in 49% of all stroke patients compared with 28% of the control subjects [adjusted OR=2.06 (95% confidence intervals (CI) 1.42-3.00)]. Haematomas, ischaemic strokes, and from the ischaemic strokes, both large and small artery disease strokes were strongly associated with positive FHS compared with the control subjects [adjusted OR=2.06 (95% CI 9-3.04), 2.07 (95% CI 1.09-3.91), 2.05 (95% CI 1.24-3.38), and 2.76 (95% CI 1.55-4.91), respectively]. There was no difference between maternal and paternal heritable contribution.In conclusion, FHS was found in this study to be an independent risk factor for all strokes combined, for each stroke type, and for the large and small-artery disease stroke subtypes, but not for the cardioembolic and undetermined stroke subtypes.