Determinants of premature familial arterial thrombosis in patients with juvenile ischaemic stroke: The Italian project on stroke in young adults (IPSYS)

Alessandro Pezzini, Mario Grassi, Corrado Lodigiani, Rosalba Patella, Carlo Gandolfo, Andrea Zini, Maria Luisa Delodovici, Maurizio Paciaroni, Massimo Del Sette, Antonella Toriello, Rossella Musolino, Rocco Salvatore Calabr Ò, Paolo Bovi, Alessan Dro Adami, Giorgio Silvestrelli, Maria Sessa, Anna Cavallini, Simona Marcheselli, Domenico Marco Bonifati, Nicoletta CheccarelliLucia Tancredi, Alberto Chiti, Lisabetta Del Zotto, Alessandra Spalloni, Paolo Costa, Giacomo Giacalone, Paola Ferrazzi, Loris Poli, Andrea Morotti, Maurizia Rasura, Anna Maria Simone, Massimo Gamba, Paolo Cerrato, Giuseppe Micieli, Maurizio Melis, Davide Massucco, Valeria De Giuli, Daniele Pepe, Licia Iacoviello, Alessandro Padovani

Research output: Contribution to journalArticle

Abstract

Factors predicting family history (FH) of premature arterial thrombosis in young patients with ischaemic stroke (IS) have not been extensively investigated, and whether they might influence the risk of post-stroke recurrence is still unknown. In the present study we analysed 1,881 consecutive first-ever IS patients aged 18–45 years recruited from January 2000 to January 2012 as part of the Italian Project on Stroke in Young Adults (IPSYS). FH of premature arterial thrombosis was any thrombotic event [IS, myocardial infarction or other arterial events event] <45 years in proband’s first-degree relatives. Compared with patients without FH of premature arterial thrombosis, those with FH (n = 85) were more often smokers (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.21–3.09) and carriers of procoagulant abnormalities (OR, 3.66; 95% CI, 2.21–6.06). Smoking (OR, 2.48; 95% CI, 1.20–5.15), the A1691 mutation in factor V gene (OR, 3.64; 95% CI, 1.31–10.10), and the A20210 mutation in the prothrombin gene (OR, 8.40; 95% CI 3.35–21.05) were associated with FH of premature stroke (n = 33), while circulating anti-phospholipids to FH of premature myocardial infarction (n = 45; OR, 3.48; 95% CI, 1.61–7.51). Mean follow-up time was 46.6 ± 38.6 months. Recurrent events occurred more frequently in the subgroup of patients with FH of premature stroke [19.4%); p = 0.051] compared to patients without such a FH. In conclusion, young IS patients with FH of premature arterial thrombosis exhibit a distinct risk-factor profile, an underlying proco-agulant state and have worse vascular prognosis than those with no FH of juvenile thrombotic events.

Original languageEnglish
Pages (from-to)641-648
Number of pages8
JournalThrombosis and Haemostasis
Volume113
Issue number3
DOIs
Publication statusPublished - 2015

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Keywords

  • Cohort studies
  • Risk factors in epidemiology
  • Stroke in young adults

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

Pezzini, A., Grassi, M., Lodigiani, C., Patella, R., Gandolfo, C., Zini, A., Delodovici, M. L., Paciaroni, M., Del Sette, M., Toriello, A., Musolino, R., Calabr Ò, R. S., Bovi, P., Adami, A. D., Silvestrelli, G., Sessa, M., Cavallini, A., Marcheselli, S., Bonifati, D. M., ... Padovani, A. (2015). Determinants of premature familial arterial thrombosis in patients with juvenile ischaemic stroke: The Italian project on stroke in young adults (IPSYS). Thrombosis and Haemostasis, 113(3), 641-648. https://doi.org/10.1160/TH14-06-0566