Association Between Recent Mechanical Risk Factors for Venous Thrombosis and Young-Onset Cryptogenic Ischemic Stroke.

Authors

Julija Valančienė, Pauli Ylikotila, Riikka Lautamäki, Marialuisa Zedde, Teresa Grimaldi, Tomi Sarkanen, Essi Ryödi, Dalius Jatužis, Kristina Ryliškienė, Diana Zakarkaitė, Bettina von Sarnowski, Raila Busch, Lauri Tulkki, Jani Pirinen, Nicolas Martinez-Majander, Radim Licenik, Phillip Ferdinand, Cheryl Oxley, Janika Kõrv, Piibe Muda, Tuukka A Helin, Lotta Joutsi-Korhonen, Tímea Szántó, Alessandro Pezzini, Carlo Mario Lombardi, Georgios Tsivgoulis, Satu Suihko, Heli Tolppanen, Ana Catarina Fonseca, Patricia Martínez-Sánchez, Laura Amaya-Pascasio, Sofie Abels, Frank-Erik de Leeuw, Nilufer Yesilot, Mine Sezgin, Ulrike Waje-Andreassen, Sahrai Saeed, Petra Redfors, Odd Bech-Hanssen, Juha Huhtakangas, Marja Hedman, Pekka Jäkälä, Hugo Ten Cate, Eva Gerdts, Mika Lehto, Juha Sinisalo, Jukka Putaala, SECRETO Study Group Investigators

Published in

Stroke. Aug 26, 2026. Epub Aug 26, 2026.

Abstract

In young adults, the risk factors (RFs) for cryptogenic ischemic stroke (CIS) remain unclear. We aimed to investigate the association between recent mechanical venous thrombosis RFs (VTRFs) and young-onset CIS in this multicenter sex- and age-matched case-control study.
Five hundred forty-six patients aged 18 to 49 years (median age, 41 [34-46] years; 47.3% women) with a recent CIS and 546 stroke-free community-based controls were included in the study across 19 European centers between October 2013 and November 2022. Mechanical VTRFs, including surgical treatment, nonsurgical intervention, injury, and immobilization occurring within 90 days prestroke, were assessed using standardized, structured interviews. Conditional logistic regression was used to assess the association of mechanical VTRFs with CIS. Age, sex, level of education, and traditional and nontraditional stroke RFs were included as confounders.
Mechanical VTRFs within 14 days prestroke were more prevalent in cases than controls (15.4% versus 9.6%) and independently associated with CIS after adjustment for demographics and traditional stroke RFs (odds ratio [OR], 1.67 [95% CI, 1.05-2.67]). In age-stratified analysis, this association remained significant after additional adjustment for nontraditional RFs in 18- to 39-year-olds (OR, 2.36 [95% CI, 1.02-5.46]) but was not significant in the 40- to 49-year age group (OR, 1.50 [95% CI, 0.73-3.08]). In addition, mechanical VTRFs were associated with CIS in cases with clinically relevant patent foramen ovale in a fully adjusted model (OR, 2.06 [95% CI, 1.21-3.51]) but not in those without (OR, 1.29 [95% CI, 0.76-2.18]). No significant associations were observed for mechanical VTRFs occurring >14 days before stroke. Baseline blood thrombophilia markers did not differ between cases with and without mechanical VTRFs 0 to 14 or 15 to 90 days before stroke.
Recent mechanical VTRFs occurring within 14 days preceding stroke contribute to the risk of young-onset CIS, particularly in younger individuals and those with a clinically relevant patent foramen ovale. This risk does not appear to be conveyed by thrombophilic factors assessed.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT01934725.

PMID:
42644242
Bibliographic data and abstract were imported from PubMed on 26 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.