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Recent bacterial and viral infection is a risk factor for cerebrovascular ischemia: clinical and biochemical studies
Insights
Recent infection significantly increases the risk of acute cerebrovascular ischemia (stroke), particularly in younger individuals. The exact mechanisms linking infection to stroke remain unclear.
Area of Science:
- Neurology
- Infectious Diseases
- Epidemiology
Background:
- Recent infection is a potential trigger for cerebrovascular events.
- Understanding the link between infection and stroke is crucial for prevention and treatment.
Purpose of the Study:
- To investigate recent infection as a stroke risk factor.
- To identify potential pathogenetic pathways connecting infection and stroke.
Main Methods:
- A case-control study involving 166 acute cerebrovascular ischemia patients and 166 controls.
- Matched controls for sex, age, and season of admission.
- Assessment of biochemical parameters in stroke subgroups with and without recent infection.
Main Results:
- Recent infection (within one week) was a significant stroke risk factor (OR 2.9).
- Both bacterial and viral infections increased stroke risk.
- Infection elevated risk for cardioembolism and arterioarterial embolism.
- No significant differences in specific coagulation and inflammatory markers were found between infected and non-infected stroke patients.
Conclusions:
- Recent infection is an independent risk factor for acute cerebrovascular ischemia.
- The influence of infection as a stroke risk factor is more pronounced in younger age groups.
- The pathogenetic mechanisms linking infection and stroke require further investigation.
Abstract:
We performed a case-control study to investigate the role of recent infection as stroke risk factor and to identify pathogenetic pathways linking infection and stroke. We examined 166 consecutive patients with acute cerebrovascular ischemia and 166 patients hospitalized for nonvascular and noninflammatory neurologic diseases. Control subjects were individually matched to patients for sex, age, and season of admission. We assessed special biochemical parameters in subgroups of stroke patients with and without recent infection (n = 21) who were similar with respect to demographic and clinical parameters. Infection within the preceding week was a risk factor for cerebrovascular ischemia in univariate (odds ratio [OR] 3.1; 95% confidence interval (CI), 1.57 to 6.1) and age-adjusted multiple logistic regression analysis (OR 2.9; 95% CI, 1.31 to 6.4). The OR of recent infection and age were inversely related. Both bacterial and viral infection contributed to increased risk. Infection elevated the risk for cardioembolism and tended to increase the risk for arterioarterial embolism. Stroke patients with and without preceding infection were not different with respect to factor VII and factor VIII activity, fibrin monomer, fibrin D-dimer, von Willebrand factor, C4b-binding protein, protein S, anticardiolipin antibodies, interleukin-1 receptor antagonist, soluble tumor necrosis factor-alpha receptor, interleukin-6, interleukin-8, and neopterin. In conclusion, recent infection is an independent risk factor for acute cerebrovascular ischemia. Its role appears to be more important in younger age groups. The pathogenetic linkage between infection and stroke is still insufficiently understood.