Fabio Gonzalez, Juan I López, Flavia Tamagnini, Pablo Bonardo, Norberto Cotti, Agustina Zavattieri, Luciana Carobolante, Carlos A Arias, Maria V Acosta, Natalia Balian, Marianela L Armaretti, Ignacio A Mena, Leonardo Gonzalez, Sandra Lepera, Santiago Claverie, Tomas D Monclá, Brain C Ureña, Patricio I Apaza, Nicole Farcy, Carolina Kerz, Adriana Luraschi, Eric Ludvik, Ignacio S Padilla, Santiago F Rea, Guillermo Bizantino, Gustavo Da Prat, Camila Antelo, Gustavo Domeniconi, Andrea Ávila, Cecilia Ferreyra, Maria L Espinosa, Luciano Cristani, Sol Lazzaneo, Marcelo Chaves, Ivana Bergagna, Priscila Galliussi, Ana Diego, Santiago Pigretti, Jorgelina Guyon, Gabriela Orzuza, Erika Torres, Alfredo Palavecino, Guadalupe Bruera, Pablo Lammertyn, Juan Jairala, Clarisa Cea, Camila Firpo, Yobana Lazarte, Sandra Mosconi, Diego Tapia, Jeronimo Cossio, Julio Fernández, María S Fernández, Gabriel Persi, Guido De Paul, Marlom H Apaza, Pilar S de Paz, Maria Caballero, Juan Cirio, Julieta Rosales, Matias Lopez, Manuel Chasco, Josefina Barber-Otero, Matias J Alet
{"title":"Young adults with ischemic stroke in Argentina: A national multicenter retrospective registry analysis (JACARANDA).","authors":"Fabio Gonzalez, Juan I López, Flavia Tamagnini, Pablo Bonardo, Norberto Cotti, Agustina Zavattieri, Luciana Carobolante, Carlos A Arias, Maria V Acosta, Natalia Balian, Marianela L Armaretti, Ignacio A Mena, Leonardo Gonzalez, Sandra Lepera, Santiago Claverie, Tomas D Monclá, Brain C Ureña, Patricio I Apaza, Nicole Farcy, Carolina Kerz, Adriana Luraschi, Eric Ludvik, Ignacio S Padilla, Santiago F Rea, Guillermo Bizantino, Gustavo Da Prat, Camila Antelo, Gustavo Domeniconi, Andrea Ávila, Cecilia Ferreyra, Maria L Espinosa, Luciano Cristani, Sol Lazzaneo, Marcelo Chaves, Ivana Bergagna, Priscila Galliussi, Ana Diego, Santiago Pigretti, Jorgelina Guyon, Gabriela Orzuza, Erika Torres, Alfredo Palavecino, Guadalupe Bruera, Pablo Lammertyn, Juan Jairala, Clarisa Cea, Camila Firpo, Yobana Lazarte, Sandra Mosconi, Diego Tapia, Jeronimo Cossio, Julio Fernández, María S Fernández, Gabriel Persi, Guido De Paul, Marlom H Apaza, Pilar S de Paz, Maria Caballero, Juan Cirio, Julieta Rosales, Matias Lopez, Manuel Chasco, Josefina Barber-Otero, Matias J Alet","doi":"10.1177/17474930251378281","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Young adults account for up to 15% of all ischemic strokes, yet data from Latin America remain scarce. Understanding their clinical profile and outcomes is essential to inform targeted interventions and public health strategies. We aimed to characterize demographics, vascular risk factors, stroke etiology, access to acute reperfusion therapies, and 90-day outcomes in Argentine patients aged 18-50 years with ischemic stroke.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter cohort study including consecutive patients aged 18-50 years with ischemic stroke, enrolled between January 2015 and December 2023 across 26 centers in Argentina. Primary outcomes were functional dependence (modified Rankin scale (mRS) 3-5), stroke recurrence, and all-cause mortality at 90 days.</p><p><strong>Results: </strong>Among 18,934 ischemic stroke patients, 1422 (7.5%) were young adults. Median age was 43 years (interquartile range (IQR) 36-47), and 53.7% (n = 763) were male. The most prevalent risk factors were hypertension (31.0% (n = 441)), smoking (29.3% (n = 417)), and obesity (18.8% (n = 267)). Median National Institute of Health Stroke Scale (NIHSS) on admission was 3 (IQR 1-8). Acute reperfusion therapy was administered in 18.9% (n = 269). Stroke etiology remained undetermined in 50.4% (n = 717) of cases; within this group, 26.1% (n = 312) fulfilled criteria for embolic stroke of undetermined source (ESUS), and 17.8% (n = 198) were cryptogenic strokes associated with patent foramen ovale. Arterial dissection accounted for 56.6% (n = 193) of other determined causes. At 90 days, functional dependence was observed in 12.1% (n = 110), stroke recurrence in 3.9% (n = 37), and mortality in 4.8% (n = 44).</p><p><strong>Conclusion: </strong>In Argentina, nearly 1 in 13 ischemic strokes occurs in young adults. Despite generally mild presentations, functional dependence and mortality remain substantial. The high rate of undetermined etiology underscores the need for standardized diagnostic protocols in this population, whose strokes carry a disproportionate individual and societal burden due to their early onset.</p>","PeriodicalId":14442,"journal":{"name":"International Journal of Stroke","volume":" ","pages":"17474930251378281"},"PeriodicalIF":8.7000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17474930251378281","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Young adults account for up to 15% of all ischemic strokes, yet data from Latin America remain scarce. Understanding their clinical profile and outcomes is essential to inform targeted interventions and public health strategies. We aimed to characterize demographics, vascular risk factors, stroke etiology, access to acute reperfusion therapies, and 90-day outcomes in Argentine patients aged 18-50 years with ischemic stroke.
Methods: We conducted a retrospective multicenter cohort study including consecutive patients aged 18-50 years with ischemic stroke, enrolled between January 2015 and December 2023 across 26 centers in Argentina. Primary outcomes were functional dependence (modified Rankin scale (mRS) 3-5), stroke recurrence, and all-cause mortality at 90 days.
Results: Among 18,934 ischemic stroke patients, 1422 (7.5%) were young adults. Median age was 43 years (interquartile range (IQR) 36-47), and 53.7% (n = 763) were male. The most prevalent risk factors were hypertension (31.0% (n = 441)), smoking (29.3% (n = 417)), and obesity (18.8% (n = 267)). Median National Institute of Health Stroke Scale (NIHSS) on admission was 3 (IQR 1-8). Acute reperfusion therapy was administered in 18.9% (n = 269). Stroke etiology remained undetermined in 50.4% (n = 717) of cases; within this group, 26.1% (n = 312) fulfilled criteria for embolic stroke of undetermined source (ESUS), and 17.8% (n = 198) were cryptogenic strokes associated with patent foramen ovale. Arterial dissection accounted for 56.6% (n = 193) of other determined causes. At 90 days, functional dependence was observed in 12.1% (n = 110), stroke recurrence in 3.9% (n = 37), and mortality in 4.8% (n = 44).
Conclusion: In Argentina, nearly 1 in 13 ischemic strokes occurs in young adults. Despite generally mild presentations, functional dependence and mortality remain substantial. The high rate of undetermined etiology underscores the need for standardized diagnostic protocols in this population, whose strokes carry a disproportionate individual and societal burden due to their early onset.
期刊介绍：
The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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