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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Embolic strokes of undetermined source in young adults: baseline characteristics and long‐term outcome
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Embolic strokes of undetermined source in young adults: baseline characteristics and long‐term outcome

机译：年轻成年人未确定来源的栓塞冲程：基线特征和长期结果

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Background and purpose Embolic strokes of undetermined source ( ESUS ) are a recent entity, not yet thoroughly investigated in young stroke patients. The clinical characteristics and long‐term risks of vascular events and all‐cause mortality between young‐onset ESUS and other aetiological subgroups were compared. Methods Patients with ESUS were identified amongst the 1008 patients aged 15?49 years with first‐ever ischaemic stroke in Helsinki Young Stroke Registry, and primary end‐points were defined as recurrent stroke, composite vascular events and all‐cause mortality. Cumulative 15‐year risks for each end‐point were analysed with life tables and adjusted risks were based on Cox proportional hazard analyses. Results Of the 971 eligible patients, 203 (20.9%) were classified as ESUS . They were younger (median age 40 years, interquartile range 32–46 vs. 45 years, 39–47), more often female (43.3% vs. 35.7%) and had fewer cardiovascular risk factors than other modified TOAST groups. With a median follow‐up time of 10.1 years, ESUS patients had the second lowest cumulative risk of recurrent stroke and composite vascular events and lowest mortality compared to other TOAST groups. Large‐artery atherosclerosis and small vessel disease carried significantly higher risk for recurrent stroke than did ESUS , whilst no difference appeared between cardioembolism from high‐risk sources and ESUS . Conclusions In our cohort, ESUS patients were younger and had milder cardiovascular risk factor burden and generally better long‐term outcome compared to other causes of young‐onset stroke. The comparable risk of recurrent stroke between ESUS and high‐risk sources of cardioembolism might suggest similarities in their pathophysiology.
机译：未确定源（eSUs）的背景和目的栓塞冲程是最近的实体，但在年轻中风患者中尚未彻底研究。比较了血管事件的临床特征和长期风险，以及幼眼症和其他治疗亚组之间的血管事件和全导致死亡率。方法鉴定了eSUS的患者，在158岁以下的患者中鉴定了赫尔辛基年轻中风注册表的第一次缺血性脑卒中，初级终点被定义为复发性卒中，复合血管事件和全导致死亡率。使用寿命表分析每个终点的累积15年风险，并根据Cox比例危害分析进行调整风险。 971个符合条件的患者的结果，203名（20.9％）被归类为ESU。他们更年轻（40年代的中位数，四分位数32-46与45岁，39-47），雌性（43.3％与35.7％），并且具有比其他改进的吐司组织更少的心血管危险因素。随着10.1岁的中位随访时间，eSus患者与其他吐司组相比，eSus患者具有第二次累积血管事件和复合血管事件的最低累积风险以及最低的死亡率。大动脉动脉粥样硬化和小血管疾病的复发性卒中风险显着高于esus，同时从高危来源和eSus之间存在脓疱疮之间没有差异。在我们的队列中，与幼小发病中风的其他原因相比，eSus患者的结论较年轻，并且具有较高的心血管风险因素负担，并且通常具有更好的长期结果。 eSus和高风险源之间的复发性卒中的可比风险可能表明其病理生理学中的相似性。

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