London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 427 265 Etiology of stroke and risk factors High incidence of diabetes and impaired fasting glucose after stroke in young adults: the FU-TURE study L.C.A. Rutten-Jacobs1, P.A.J. Keurlings2, R.M. Arntz3, N.A.M. Maaijwee4, H.C. Schoonderwaldt5, L.D. Dorresteijn6, E.J. van Dijk7, F-E de Leeuw8 Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, THE NETHERLANDS1, Radboud Univer-sity Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, THE NETHERLANDS2, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, THE NETHERLANDS3, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, THE NETHERLANDS4, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, De-partment of Neurology, Nijmegen, THE NETHERLANDS5, Department of Neurology, Medisch Spectrum Twente, the Netherlands, Enschede, THE NETHERLANDS6, Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, THE NETHERLANDS7, Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Be-haviour, Department of Neurology, Nijmegen, THE NETHERLANDS8 Background: Young stroke patients are at high risk of recurrent (cerebro)vascular events or death, which is even increased in patients with a medical history of diabetes. Also impaired fasting glucose (IFG) has been associated with recurrent vascular events in the general stroke population. Due to limited long-term monitoring after stroke in young adults, new evolving diabetes and IFG may re-main unnoticed for a long time. Consequently, data on the incidence after young stroke are lacking. Therefore we investigated the long-term incidence of diabetes and IFG after young stroke. Methods: The FUTURE study comprises all consecutive TIA, ischemic stroke and intracerebral hemorrhage patients, aged 18-50, included in a prospective registry between 1980-2010. Patients alive were invited for a follow-up assessment between 1-11-2009 and 1-1-2012 and were evaluated for diabetes and IFG by standardized structured questionnaires, combined with the assessment of fasting venous plasma glucose. Results: 481 patients were included in the present analysis (mean follow-up of 10.1yrs, SD 8.3; age 40.0 yrs, SD 8.0). 18 patients (3.7%) had diabetes prior to the index event. During follow-up 11 (7.0%) patients with TIA and 23 (8.5%) patients with ischemic stroke developed diabetes. Incident IFG was present in 19 (12.1%), 28 (10.3%) and 2 (5.9%) patients with TIA, ischemic stroke and intracerebral hemorrhage respectively. Incident diabetes was independently predicted by likely ath-erothrombotic stroke subtype, a first degree family member with diabetes and age of the index event (OR 2.7 (95% CI 1.1-6.8), OR 2.5 (95% CI 1.1-5.5) and OR 1.2 (95% CI 1.1-1.3) respectively). In-cident IFG was independently predicted by sex and age of the index event (OR 2.4 (95% CI 1.2-4.7) and OR 1.1 (1.1-1.2) respectively). Conclusion: Almost one out of five young adults develops diabetes or IFG in 10 years after stroke. Screening for these conditions yields a potential for secondary prevention. 266 Etiology of stroke and risk factors Frequent atrial ectopic activity and risk of recurrent cryptogenic ischemic stroke and tran-sient ischemic attack J. Pinho1, C. Galvão2, S. Rocha3, A.F. Santos4, A. Cabreiro5, A. Gomes6, S. Magalhães7, C. Ferrei-ra8 Neurology Department, Hospital de Braga, Braga, PORTUGAL1, Cardiology Department, Hos-pital de Braga, Braga, PORTUGAL2, Neurology Department, Hospital de Braga, Braga, PORTU-GAL3, Neurology Department, Hospital de Braga, Braga, PORTUGAL4, Cardiology Department, Hospital de Braga, Braga, PORTUGAL5, Internal Medicine Department, Hospital de São João; De-partment of Hygiene and Epidemiology, University of Porto Medical School, Porto, PORTUGAL6, Cardiology Department, Hospital de Braga, Braga, PORTUGAL7, Neurology Department, Hospital de Braga, Braga, PORTUGAL8 BACKGROUND: Frequent atrial ectopic activity (FAEA) was recognized as a risk factor for parox-ysmal atrial fibrillation, first ischemic stroke and death. Its occurrence in patients with cryptogenic cerebral ischemic events (CCIE) is poorly studied and its role as a risk factor for stroke/TIA recur-rence in these patients is unknown. METHODS: We retrospectively identified patients who had un-dergone Holter monitoring in our hospital between 2005 and 2012, who had ischemic stroke or TIA of undetermined etiology (CCIE) according to TOAST classification. Demographic, clinical and imaging data were collected and patients were classified according to ASCO phenotype. We defined FAEA as occurrence of >10 atrial ectopic beats (AEB) per hour. Recurrence of ischemic stroke or TIA during hospital follow-up was recorded. RESULTS: 184 patients with CCIE were identified and followed for a median of 28 months (IQR 12.4-55.0) –52.2% male, median age 56 years. Ischemic stroke was the index event in 73.9% and TIA in 26.1%. Recurrence rate was 3.1 per 100 patients/ year in patients without FAEA (n=152), and 17.6 per 100 patients/year in patients with FAEA (n=32) (p<0.001). Patients with and without recurrences differed significantly regarding age, arterial hyper-tension and presence of FAEA. Univariate analysis revealed increased risk of recurrence in patients >65 years (HR=3.98, p=0.002) and presence of FAEA (HR=4.52, p=0.001). Risk of recurrence was higher, albeit non significant, in patients with FAEA (HR=2.49, p=0.087) in multivariate analysis adjusted for age, arterial hypertension and anticoagulation. CONCLUSION: This study suggests that FAEA is associated with an increased risk of recurrent cryptogenic ischemic stroke or TIA. Although this association is weakened in multivariate analysis, we argue that there is a trend for in-creased recurrence in patients with FAEA. Atrial ectopic activity prospective studies in this group of patients may have a significant impact in clinical practice.
Karger_ESC London_2013
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