Key result
Cryptogenic stroke in young adults linked to ~86% greater odds of abnormal LV geometry.
Why the study?
Cardiac organ damage is associated with increased cardiovascular disease risk, but limited knowledge exists regarding cardiac organ damage in young patients with cryptogenic ischaemic stroke.
Do young adults with cryptogenic ischaemic stroke have a higher prevalence of cardiac organ damage compared to stroke-free controls?
Case-Control (n=788)
Blinded central analysis
Yes
Do young adults with cryptogenic ischaemic stroke have a higher prevalence of cardiac organ damage compared to stroke-free controls?
Effect estimate: OR 1.86 (95% CI 1.09-3.20)
Absolute Event Rate: 12% vs 7%
p-value: p=0.024
Young adults with cryptogenic ischaemic stroke have a significantly higher prevalence of abnormal left ventricular geometry compared to matched controls, highlighting the importance of blood pressure and weight control to prevent cardiac organ damage progression.
Prioritizes BP and weight optimization in young cryptogenic stroke; hypothesis-generating for cardiac organ damage and requires prospective validation.
Cardiac organ damage (OD) is associated with increased risk of cardiovascular disease. However, limited knowledge exists on cardiac OD in young patients with cryptogenic ischaemic stroke (CIS). To explore prevalence and covariates of cardiac OD in patients with CIS compared to controls participating in the SECRETO study. We analysed data from 427 patients with CIS aged <50 years and 361 age- and sex-matched controls. OD was defined as presence of abnormal left ventricular (LV) geometry (LV hypertrophy or concentric remodelling) or left atrial enlargement (LAE) assessed by echocardiography, using sex-specific threshold values. Compared to controls, patients had higher prevalences of obesity and tobacco smoking, patent foramen ovale (PFO) (52% vs. 25%) and abnormal LV geometry (12% vs. 7%, all p < 0.01), while presence of LAE did not differ. In multivariable analyses, CIS was associated with presence of abnormal LV geometry (odds ratio 1.86 [95% confidence interval 1.09–3.20], p=0.024). In separate multivariable analyses in patients only, obesity was associated with both abnormal LV geometry and LAE (both p < 0.01), and higher systolic blood pressure only with presence of abnormal LV geometry (p < 0.001). No significant association with PFO was found. In young patients with CIS participating in the SECRETO study, abnormal LV geometry was more prevalent compared to age- and sex-matched controls and associated with presence of higher blood pressure and obesity. The results point to the importance of blood pressure and weight control in CIS to prevent progression of cardiac OD and recurrent cardiovascular events.
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Eilertsen et al. (2026) conducted a case-control in Cryptogenic Ischaemic Stroke (n=788). Cryptogenic Ischaemic Stroke vs. Age- and sex-matched stroke-free controls was evaluated on Abnormal left ventricular geometry (OR 1.86, 95% CI 1.09-3.20, p=0.024). Cryptogenic ischaemic stroke in young adults was associated with a significantly higher prevalence of abnormal left ventricular geometry compared to stroke-free controls (12% vs. 7%, OR 1.86).
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