Preceding Infections and Coagulation Biomarkers in Early-Onset Cryptogenic Ischemic Stroke

Area of Science:

• Neurology
• Immunology
• Hematology

Background:

• Infections may trigger ischemic stroke via thromboinflammatory pathways, particularly in young patients with cryptogenic ischemic stroke (CIS).
• Understanding the link between infections and CIS is crucial for identifying at-risk populations and potential preventive strategies.

Purpose of the Study:

• To assess the association between preceding infections and CIS in young adults.
• To investigate the relationship between infection characteristics and coagulation biomarkers in patients with CIS.

Main Methods:

• A multicenter case-control study (SECRETO) involving 537 matched pairs of young CIS patients and controls.
• Infections within 3 months of stroke onset were assessed via questionnaire; coagulation biomarkers (VWF, FVIII, fibrinogen, antithrombin III, protein C) were measured.

Main Results:

• Infections within the preceding week were linked to a 2.6-fold increase in CIS odds.
• Elevated von Willebrand Factor (VWF) activity was observed in CIS cases compared to controls, especially in those with recent infections.
• Increased VWF and factor VIII levels were associated with higher stroke odds in participants with recent infections or fever.

Conclusions:

• Recent infections are associated with increased odds of early-onset CIS in young adults.
• VWF and factor VIII play a significant role in infection-related CIS, highlighting thromboinflammatory mechanisms.
• Further research is needed to elucidate these mechanisms and explore preventive measures for infection-related CIS.