Abstract Details

Title AISYF: Argentinean Initiative of Stroke in the Young and Fabry Disease (FD)

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 038

Objective

Background BACKGROUND: Up to 10% of all strokes occur in young patients, causing great morbidity and mortality in this group. One third of CVA remain cryptogenic despite extensive evaluation. FD is as an underdiagnosed etiology of stroke in the young, but the frequency of this association is still controversial. There are not registries of young patients with stroke in Argentina and therefore the frequency of FD in this population has never been investigated.

Design/Methods DESIGN/METHODS: This is a prospective, multicentric study of stroke and FD in young adults (18-55 years) in Argentina. Patients included, presented their stroke within 180 days. Stroke subtype was classified based on TOAST criteria. FD was diagnosed by measurement of alpha-galactosidase-A activity (males) and genetic studies were performed in all females and males with altered enzyme activity. A thrombophilia panel was performed in 75 patients.

Results RESULTS: Since January 2011, 127 patients were enrolled (67 men, 60 women: mean age: 44 years). Ischemic strokes (IS) occurred in 117 (92%) patients (infarcts 84%, TIA 8%) and hemorraghic strokes in 10 (8%) patients. Stroke subtypes were: large artery disease 17%, cardioembolism 9%, small - artery occlusion 12%, other defined etiology 24%, undetermined etiology 38%. Cardiovascular risk factors for IS were: hypertension 45%, diabetes 14%, hyperlipidemia 37%, smoking 34% and obesity 25%. Enzymatic studies for FD were normal and genetic studies in females are being completed. One patient had an antiphospholipid syndrome and a second presented homozygous factor V Leiden. No other relevant thrombophilic factors were found.

Conclusions CONCLUSIONS: Although FD was not yet identified in our cohort its early recognition in young patients with stroke is essential for appropiate treatment. Despite extensive investigations stroke of undetermined etiology remains a frequent challenge in young patients.

Authors/Disclosures
Ricardo C. Reisin, MD (Hospital Britanico) PRESENTER	Dr. Reisin has nothing to disclose.
Wade S. Smith, MD, PhD (University of California, San Francisco)	Dr. Smith has stock in MindRhythm, Inc. The institution of Dr. Smith has received research support from NIH. Dr. Smith has received intellectual property interests from a discovery or technology relating to health care. Dr. Smith has received publishing royalties from a publication relating to health care.

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