228 Scientific Programme 22. European Stroke Conference © 2013 S. Karger AG, Basel 16 Etiology of stroke and risk factors Cervical Artery Dissection: Trauma and other potential mechanical trigger events S.T. Engelter1, C. Grond-Ginsbach2, T. Metso3, V. Caso4, A. Pezzini5, H. Gensicke6, A. Bersano7, M Kloss8, J. Martin9, S. Debette10, D. Leys11, E. Touzé12, T. Tatlisumak13, P.A. Lyrer14, T. Brandt15 Cervical Artery Dissection and Ischemic Stroke Patients (CADISP)-Study Group Stroke Unit, Department of Neurology, Basel, Basel, SWITZERLAND1, University Hospital Heidelberg, Heidelberg, GERMANY2, Stroke Unit University Hospital Helsiniki, Helsinki, GER-MANY3, 8Stroke Unit, Perugia University, Perugia, ITALY4, University of Brescia, Brescia, ITA-LY5, Stroke Unit, Department of Neurology, Basel, Basel, SWITZERLAND6, University Milan, Mi-lan, ITALY7, University Hospital Heidelberg, Heidelberg, GERMANY8, Department of Neurology, Sanatorio Allende, Cordoba, Cordoba, ARGENTINA9, University Lille Nord de France, EA 1046, Lille, FRANCE10, University Lille Nord de France, EA 1046, Lille, FRANCE11, Department of Neurology, Sainte-Anne Hospital, Paris, Paris, FRANCE12, Stroke Unit University Hospital Helsiniki, Finland, FINLAND13, Stroke Unit, Department of Neu-rology, Basel, Basel, SWITZERLAND14, Clinics for Neurologic Rehabilitation, Kliniken Schmied-er, Heidelberg, Heidelberg, GERMANY15 Objective: To examine the importance of prior cervical trauma (PCT) in patients with cervical artery dissection (CeAD). Methods: In this observational study, the presence and the type of PCT were systematically ascer-tained in CeAD patients using two different populations for comparisons: (i) age-and sex-matched patients with ischemic stroke attributable to a cause other than CeAD (non-CeAD-IS patients) and (ii) healthy subjects participating in the Cervical–Artery-Dissection-and-Ischemic-Stroke-Patients (CADISP) study. The presence of PCT within 1 month was assessed using a standardized question-naire. Crude odds ratios (OR) with 95%-confidence intervals (95%-CI) and OR adjusted for age, sex and center were calculated. Results: We analyzed 1897 participants (N=966 with CeAD, N=651 with non-CeAD-IS, N=280 healthy subjects). CeAD patients had PCT in 40.5% 38.2-44.5% of cases, with 88% (344/392) classified as mild. PCT was more common in CeAD patients than in non-CeAD-IS patients (OR-crude 5.6 95%-CI 4.20-7.37, p<0.001; ORadjusted 7.6 95%-CI 5.60-10.20, p<0.001) or healthy subjects (ORcrude 2.8 95%-CI 2.03-3.68, p<0.001; ORadjusted 3.7 95%-CI 2.40-5.56, p<0.001). CeAD patients with PCT were younger and presented more often with neck pain and less often with stroke than CeAD patients without PCT. PCT was not associated with functional 3-month-outcome, after adjustment for age, sex, and stroke severity. Conclusion: Prior cervical trauma seems to be an important environmental determinant of CeAD, but was not an independent outcome predictor. Due to the characteristics of most prior cervical trau-mas, the term “mechanical trigger event” rather than trauma, may be more appropriate 15 Etiology of stroke and risk factors Genome wide analysis of blood pressure variability in ischemic stroke S. Yadav1, I. Cotlarciuc2, P. Sharma3 Imperial College Cerebrovascular Research Unit, London, UNITED KINGDOM1, Imperial College Cerebrovascular Research Unit, London, UNITED KINGDOM2, Imperial College Cerebro-vascular Research Unit, London, UNITED KINGDOM3 Background: Visit-to-visit variability in BP has been associated with ischemic stroke. We sought to determine whether such variability has a genetic aetiology and if so, whether genetic variants associ-ated with BP variability are also associated with ischemic stroke. Methods: A GWAS for loci influencing BP variability was undertaken in 3,802 individuals from the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT) study where visit-to-visit BP measures were available. The most strongly associated SNP was then tested for association with ischemic stroke in an independent ischemic stroke population comprising 8,624 cases and 12,722 controls from 7 co-horts. Results: The ASCOT study identified a cluster of 17 highly correlated SNPs within the NLGN1 gene (3q26.31) associated with BP variability. The strongest association reaching genome wide sig-nificance was at rs976683 (p=1.7 x 10-8). Conditional analysis on rs976683 provided no further ev-idence of an independent signal at any of the other loci. The lead SNP rs976683 was then tested in a large group of patients with ischemic stroke. No association was observed for overall stroke (OR 1.02; 95% CI 0.97-1.07; p=0.52) or its sub-types: cardio embolic stroke (OR 1.07; 95% CI 0.97- 1.16; p=0.17), large vessel disease (OR 0.98; 95% 0.89-1.07; p=0.60) and small vessel disease (OR 1.07; 95% CI 0.97-1.17; p=0.19). Conclusion: Our results identified a SNP showing significant association with BP variability. How-ever, this SNP was not associated with an increased risk of ischemic stroke or ist subtypes.
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