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Family History in Young Patients With Stroke
Vincent Thijs1, Ulrike Grittner2, Martin Dichgans2
1From the Department of Neurosciences, Experimental Neurology, KU Leuven, University of Leuven, Leuven, Belgium (V.T.); Department of Neurology, VIB-Vesalius Research Center, University Hospitals Leuven, Leuven, Belgium (V.T.); Center for Stroke Research (U.G.) and Department for Biostatistics and Clinical Epidemiology (U.G.), Charité-University Medical Centre Berlin, Berlin, Germany; Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany (M.D.); The German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich, Germany (M.D.); Department of Neurology, Medical University of Graz, Graz, Austria (C.E., F.F., R.S.); Albrecht-Kossel-Institute for Neuroregeneration (AKos), Centre for Mental Health Disease (A.-K.G., A.R.) and Institute of Medical Psychology and Medical Sociology Medical Faculty (P.K.), University of Rostock, Rostock, Germany; Department of Neurology, University Medicine Greifswald, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany (C.K., B.v.S.); Department of Neurology, New York University School of Medicine (E.K.); Institut für Klinische Epidemiologie und Angewandte Biometrie (IKEaB), Tübingen, Germany (P.M.); Department of Clinical Sciences Neurology, Lund University, Lund, Sweden (B.N.); Wilhelms University of Muenster, Muenster, Germany (E.B.R.); Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom (P.M.R.); Department of Neurology, Justus Liebig University Giessen, Giessen, Germany (C.T.); and Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (T.T.). vincent.thijs@uzleuven.be.
Insights
A family history of stroke is common in young patients but not linked to specific stroke subtypes. However, young women with stroke are more likely to have a maternal history of stroke.
Area of Science:
- Neurology
- Genetics
- Epidemiology
Background:
- Family history of stroke is a known risk factor.
- Investigating its role in young stroke patients is crucial.
Purpose of the Study:
- To determine if family history of stroke predisposes to specific stroke subtypes.
- To examine sex differences in family history of stroke among young stroke patients.
Main Methods:
- Utilized data from the prospective Stroke in Fabry Patients study.
- Included young patients (<55 years) with transient ischemic attack and ischemic stroke.
- Collected data on cardiovascular risk factors, family history, and detailed stroke subtyping.
Main Results:
- 37.3% of patients had a family history of stroke.
- Female patients more frequently reported maternal lineage stroke history.
- No association found between family history and stroke subtype or white matter disease.
- Patients with dissection less frequently reported family history of stroke.
Conclusions:
- Family history of stroke is not specifically related to pathogenic stroke subtypes in young patients.
- Young women with stroke more often report stroke in their maternal lineage.
Background And Purpose:
Family history of stroke is an established risk factor for stroke. We evaluated whether family history of stroke predisposed to certain stroke subtypes and whether it differed by sex in young patients with stroke.
Methods:
We used data from the Stroke in Fabry Patients study, a large prospective, hospital-based, screening study for Fabry disease in young patients (aged <55 years) with stroke in whom cardiovascular risk factors and family history of stroke were obtained and detailed stroke subtyping was performed.
Results:
A family history of stroke was present in 1578 of 4232 transient ischemic attack and ischemic stroke patients (37.3%). Female patients more often had a history of stroke in the maternal lineage (P=0.027) than in the paternal lineage. There was no association with stroke subtype according to Trial of Org 10172 in Acute Stroke Treatment nor with the presence of white matter disease on brain imaging. Patients with dissection less frequently reported a family history of stroke (30.4% versus 36.3%; P=0.018). Patients with a parental history of stroke more commonly had siblings with stroke (3.6% versus 2.6%; P=0.047).
Conclusions:
Although present in about a third of patients, a family history of stroke is not specifically related to stroke pathogenic subtypes in patients with young stroke. Young women with stroke more often report stroke in the maternal lineage.
Clinical Trial Registration:
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583.
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