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Published on: February 23, 2016

Risk factor burden predicts long-term mortality in young patients with arterial cerebral infarction

H Naess1, U Waje-Andreassen, H Nyland

  • 1Department of Neurology, Haukeland University Hospital, Bergen, Norway. haln@haukeland.no

Acta Neurologica Scandinavica
|May 24, 2012
PubMed

Insights

Young adults experiencing arterial cerebral infarction face increased long-term mortality risk with more traditional risk factors. Aggressive secondary prevention is crucial for those with multiple risk factors.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Arterial cerebral infarction in young adults (<50 years) presents unique challenges for long-term prognosis.
  • Understanding the cumulative impact of traditional risk factors on mortality is essential for effective patient management.

Purpose of the Study:

  • To investigate the independent and combined effects of traditional risk factors on long-term mortality following arterial cerebral infarction in young adults.
  • To identify specific risk factors associated with increased mortality in this demographic.

Main Methods:

  • A population-based cohort study of young adults (<50 years) with a first-ever arterial ischemic stroke.
  • Utilized Cox regression analyses to assess mortality risk associated with the number and type of risk factors (smoking, hypertension, hypercholesterolemia, diabetes mellitus, myocardial infarction, angina pectoris, intermittent claudication, alcoholism).
  • Mean follow-up duration of 18 years, representing the longest follow-up in studies of young adults post-cerebral infarction.

Main Results:

  • Mortality rates significantly increased with the number of risk factors: 12.5% (no risk factors) vs. 18.5% (1-3 risk factors) vs. 25.4% (4-5 risk factors) vs. 53.1% (≥6 risk factors) (P < 0.001).
  • The cumulative number of risk factors was significantly associated with mortality (Hazard Ratio [HR] = 1.6, P = 0.001).
  • Individual risk factors strongly linked to mortality included diabetes mellitus (HR = 3.0, P = 0.001), myocardial infarction (HR = 3.1, P = 0.001), and alcoholism (HR = 6.3, P < 0.001).

Conclusions:

  • An increasing burden of traditional cardiovascular risk factors is significantly associated with long-term mortality in young adults who have experienced a cerebral infarction.
  • These findings underscore the critical need for intensified and tailored long-term secondary preventive strategies in young stroke survivors, particularly those with multiple risk factors.
Abstract

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