TOUlouse TAhiTI Stroke Study (TOUTATIS): A comparative analysis of young pacific islanders with ischemic stroke

IF 2.8 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique Pub Date : 2025-04-01 DOI:10.1016/j.neurol.2025.01.413

R. Buon , C. Tessier , L. Watrin , G. Gueyraud , V. Larrue , C. Gollion

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引用次数: 0

Abstract

Background and purpose

Incidence of stroke among young adults is on the rise worldwide. Inequities remain among minorities and little is known about stroke characteristics among young Pacific patients. French Polynesia (FP), located in the middle of the South Pacific Ocean, could provide insight into this problem.

Methods

Patients aged 18–54 years consecutively treated for first-ever acute ischemic stroke in Tahiti, FP, from January 2022 to December 2023 were compared to a reference cohort enrolled from January 2017 to July 2021 in Toulouse, France. Patients’ characteristics were recorded and cause of stroke was classified using the ASCOD (A: atherosclerosis; S: small vessel disease; C: cardiac pathology; O: other causes; D: dissection) classification system.

Results

In total, 187 patients were included in Tahiti (Polynesians) and compared to 743 patients in Toulouse (mainland French [MF]). Median age was 47 years old in both groups. Hypertension, diabetes, hyperlipidemia, obesity, atrial fibrillation and mechanical valve were significantly higher in Polynesian patients, whereas MF patients were more likely to be men, tobacco users, and to have a stroke related to a foramen oval with atrial septal aneurysm (all P < 0.05). Multivariate analysis revealed higher prevalence of grade 1 (potentially causal) atherothrombotic (adjusted OR [aOR]: 1.775; 95% CI: 1.117–2.820; P = 0.015) and cardio-embolic stroke in Tahiti (aOR: 2.966; 95% CI: 1.956–4.496; P < 0.001), and higher rate of dissections in Toulouse (aOR: 4.545; 95% CI: 1.616–12.821; P = 0.004). Cervical atherosclerosis was significantly associated with MF patients (aOR: 5.587; 95% CI: 2.326–13.514; P < 0.001), and intracranial atherosclerosis with Polynesian patients (aOR: 3.257; 95% CI: 1.364–7.778; P = 0.008).

Conclusion

Polynesian and MF young adults with stroke appeared to have widely different characteristics and cause of stroke. These disparities underscore the necessity for tailored prevention programs and therapeutic approaches that address the unique risk profile and etiological patterns observed in Pacific Islanders.

Abstract Image

查看原文本刊更多论文

图卢兹大溪地卒中研究（TOUTATIS）：太平洋岛民缺血性卒中的比较分析。

背景和目的：世界范围内年轻人中风的发病率呈上升趋势。在少数民族中仍然存在不公平现象，对太平洋地区年轻患者的中风特征知之甚少。位于南太平洋中部的法属波利尼西亚（FP）可以为这个问题提供见解。方法：将2022年1月至2023年12月在FP塔希提岛连续接受首次急性缺血性卒中治疗的18-54岁患者与2017年1月至2021年7月在法国图卢兹入组的参考队列进行比较。记录患者的特征，并使用ASCOD (A：动脉粥样硬化；S：小血管疾病；C：心脏病理；O：其他原因；D：解剖)分类系统。结果：塔希提岛（波利尼西亚）共纳入187例患者，而图卢兹岛（法国大陆[MF]）共纳入743例患者。两组患者的中位年龄均为47岁。高血压、糖尿病、高脂血症、肥胖、房颤和机械瓣膜在波利尼西亚患者中明显较高，而MF患者更可能是男性、吸烟者，并且卒中与卵圆孔伴房间隔动脉瘤相关（均为p）。结论：波利尼西亚和MF青年卒中患者似乎具有广泛不同的特征和卒中原因。这些差异强调有必要针对太平洋岛民中观察到的独特风险概况和病因模式制定量身定制的预防规划和治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revue neurologique 医学-临床神经学

CiteScore

4.80

自引率

0.00%

发文量

598

审稿时长

55 days

期刊介绍： The first issue of the Revue Neurologique, featuring an original article by Jean-Martin Charcot, was published on February 28th, 1893. Six years later, the French Society of Neurology (SFN) adopted this journal as its official publication in the year of its foundation, 1899. The Revue Neurologique was published throughout the 20th century without interruption and is indexed in all international databases (including Current Contents, Pubmed, Scopus). Ten annual issues provide original peer-reviewed clinical and research articles, and review articles giving up-to-date insights in all areas of neurology. The Revue Neurologique also publishes guidelines and recommendations. The Revue Neurologique publishes original articles, brief reports, general reviews, editorials, and letters to the editor as well as correspondence concerning articles previously published in the journal in the correspondence column.