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Stroke in first-degree relatives of patients with cervical artery dissection

M Kloss1,2, C Grond-Ginsbach1, A Pezzini3

  • 1Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.

European Journal of Neurology
|April 5, 2014
PubMed

Insights

Patients with cervical artery dissection (CeAD) stroke have a lower frequency of family history of stroke (FHS) at a young age compared to other ischemic stroke patients. This suggests a reduced genetic predisposition for early-onset stroke in CeAD families.

Area of Science:

  • Neurology
  • Genetics
  • Epidemiology

Background:

  • Cervical artery dissection (CeAD) is a cause of ischemic stroke (IS).
  • Patients with CeAD often express concern about a potential increased risk of stroke within their families.
  • Understanding familial stroke risk is crucial for patient counseling and risk assessment.

Purpose of the Study:

  • To compare the occurrence of stroke in first-degree relatives of patients with CeAD versus those with IS from other causes.
  • To investigate the association between family history of stroke (FHS) at different age thresholds (≤50 and >50 years) and CeAD.
  • To identify potential differences in stroke risk among relatives of IS patients based on the underlying cause of the patient's stroke.

Main Methods:

  • A comparative study using the Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) database.
  • Inclusion of IS patients with CeAD and age-/sex-matched non-CeAD IS patients.
  • Assessment of family history of stroke (FHS) defined by stroke occurrence in relatives at age ≤50 years (FHS ≤50) and >50 years (FHS >50).
  • Analysis correlated FHS with patient demographics, vascular risk factors (hypertension, hypercholesterolemia, smoking, BMI), and number of siblings.

Main Results:

  • A total of 1225 patients were analyzed.
  • Family history of stroke ≤50 years (FHS ≤50) was significantly less frequent in CeAD patients (2.5%) compared to non-CeAD IS patients (6.1%) (P=0.003).
  • This association remained significant after adjusting for age, sex, and number of siblings (P=0.005).
  • The frequency of FHS >50 years was similar between the two groups.
  • Vascular risk factors did not differ between patients with positive or negative FHS ≤50, but FHS >50 was associated with hypertension and higher BMI.

Conclusions:

  • Relatives of patients with cervical artery dissection (CeAD) experience fewer strokes at a young age compared to relatives of patients with non-CeAD ischemic stroke.
  • This finding suggests a potentially lower genetic predisposition for early-onset stroke in families affected by CeAD.
  • Further research may elucidate the specific genetic and environmental factors contributing to these differences.
Abstract

Keywords:
cervical artery dissection (CeAD)family history of stroke (FHS)young stroke

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