Endothelial Dysfunction is Associated With Early-Onset Cryptogenic Ischemic Stroke in Men and With Increasing Age

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Martinez-Majander , N , Gordin , D , Joutsi-Korhonen , L , Salopuro , T , Adeshara , K , Sibolt , G , Curtze , S , Pirinen , J , Liebkind , R , Soinne , L , Sairanen , T , Sinisalo , J , Lehto , M , Groop , P-H , Tatlisumak , T & Putaala , J 2021 , ' Endothelial Dysfunction is Associated With Early-Onset Cryptogenic Ischemic Stroke in Men and With Increasing Age ' , Journal of the American Heart Association , vol. 10 , no. 14 , 020838 . https://doi.org/10.1161/JAHA.121.020838

Title: Endothelial Dysfunction is Associated With Early-Onset Cryptogenic Ischemic Stroke in Men and With Increasing Age
Author: Martinez-Majander, Nicolas; Gordin, Daniel; Joutsi-Korhonen, Lotta; Salopuro, Titta; Adeshara, Krishna; Sibolt, Gerli; Curtze, Sami; Pirinen, Jani; Liebkind, Ron; Soinne, Lauri; Sairanen, Tiina; Sinisalo, Juha; Lehto, Mika; Groop, Per-Henrik; Tatlisumak, Turgut; Putaala, Jukka
Other contributor: University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUSLAB
University of Helsinki, HUSLAB
University of Helsinki, HUS Neurocenter
University of Helsinki, Clinicum
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Neurocenter
University of Helsinki, Department of Neurosciences
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Staff Services
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
















Date: 2021-07-20
Language: eng
Number of pages: 12
Belongs to series: Journal of the American Heart Association
ISSN: 2047-9980
DOI: https://doi.org/10.1161/JAHA.121.020838
URI: http://hdl.handle.net/10138/334450
Abstract: Background The aim of this study was to assess the association between endothelial function and early-onset cryptogenic ischemic stroke (CIS), with subgroup analyses stratified by sex and age groups. Methods and Results We prospectively enrolled 136 consecutive patients aged 18 to 49 years (median age, 41 years; 44% women) with a recent CIS and 136 age- and sex-matched (+/- 5 years) stroke-free controls. Endothelial function was measured with an EndoPAT 2000 device and analyzed as tertiles of natural logarithm of reactive hyperemia index with lower values reflecting dysfunction. We used conditional logistic regression adjusting for age, education, hypertension, diabetes mellitus, dyslipidemia, current smoking, heavy drinking, obesity, and diet score to assess the independent association between endothelial function and CIS. Patients in the lowest tertile of natural logarithm of reactive hyperemia index were more often men and they more frequently had a history of dyslipidemia; they were also more often obese, had a lower diet score, and lower high-density lipoprotein cholesterol. In the entire cohort, we found no association in patients with endothelial function and CIS compared with stroke-free controls. In sex- and age-specific analyses, endothelial dysfunction was associated with CIS in men (adjusted odds ratio [OR], 3.50 for lowest versus highest natural logarithm of reactive hyperemia index tertile; 95% CI, 1.22-10.07) and in patients >= 41 years (OR, 5.78; 95% CI, 1.52-21.95). These associations remained significant when dyslipidemia was replaced with the ratio of total to high-density lipoprotein cholesterol. Conclusions Endothelial dysfunction appears to be an independent player in early-onset CIS in men and patients approaching middle age.
Subject: brain infarction
cryptogenic stroke
endothelial function
ischemic stroke
microcirculation
risk factors
young adults
PERIPHERAL ARTERIAL TONOMETRY
GLYCATED ALBUMIN
YOUNG-ADULTS
VASCULAR FUNCTION
RELIABILITY
REPRODUCIBILITY
EXPLANATIONS
DIAGNOSIS
ETIOLOGY
TRIGGERS
3121 General medicine, internal medicine and other clinical medicine
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