Acute non-alcoholic caffeinated beverage consumption as a trigger for cryptogenic ischemic stroke in the young:...

Cryptogenic ischemic stroke (CIS) is responsible for the increase in young ischemic strokes. We investigated non-alcoholic caffeinated beverages as a trigger for young CIS, in a large multi-center, case-control study.

In Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725), patients 18-49 years old suffering first ever CIS were recruited within 2 weeks of symptom onset. A structured questionnaire obtained information on coffee, tea, and cola consumption in the last 12 months, usual daily consumption, consumption 24 h preceding stroke and timing of the last consumption prior to stroke. Case-crossover analysis was performed using the Mantel-Haenszel method.

598 CIS patients (54.7% male, mean age 39.4 [standard deviation 8.2]) were analyzed. Case-crossover analysis found association with coffee consumption in the 1-h (relative risk [RR] 1.73, 95% confidence interval [CI] 1.06-2.83) and 2-h (RR 2.15, 95%CI 1.40-3.29) hazard periods, tea consumption in the 1-h (RR 3.93, 95%CI 1.04-14.95) and 2- hour (RR 4.89, 95%CI 1.92-12.50) hazard periods and cola consumption (RR 3.70, 95%CI 1.18-11.62) in the 2-h hazard period. Sub-group analysis in the 2-h hazard period found coffee consumption was associated in both sexes and age groups, high-risk patent foramen ovale (PFO), mild/moderate stress and both low-/high-risk factor burden. Tea consumption was associated in both sexes and age groups and those without PFO.

Coffee, tea, and cola consumption as potential trigger factors were associated with young CIS patients within the 2-h hazard period, with coffee and tea maintaining association in several sub-groups.