Heavy smoking linked to significant risk for cryptogenic ischemic stroke
Key takeaways:
- Those who smoked more than 20 packs a year had more than four times the risk for cryptogenic ischemic stroke vs. nonsmokers.
- The risk was highest in patients aged 45 to 49 years.
Heavy smoking was associated with a significantly increased risk for cryptogenic ischemic stroke within a large cohort of younger adults from across Europe, data show.
“Smoking is a well-documented risk factor of ischemic stroke and has been shown to have a high prevalence in young ischemic strokes, varying between 40.9% and 55.5% in the largest cohorts, with a trend toward an impact on long-term recurrence,” Philip Ferdinand, MBChB, MRCP, a member of the stroke research group at Keele University, and colleagues wrote in Neurology Open Access.
The researchers investigated associations between smoking and cryptogenic ischemic stroke (CIS) in a large, multicenter case-control study of adults aged 18 to 49 years conducted between November 2013 and November 2022.
Their study, Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO), included 546 individuals (47.3% women; 94.3% white) with CIS, recruited within 2 weeks of symptom onset from 19 European stroke centers, who were matched by both age and sex to a stroke-free control.
A comprehensive baseline questionnaire solicited participant data on tobacco use and intensity, defined in binary terms as “current smoker,” (one or more cigarettes in the previous 12 months) or “ex-smoker,” (smoked, but not in the previous 12 months). Additional data culled from the questionnaire included education level, alcohol use and comorbidities related to a range of cardiovascular and other health factors.
Data showed significant differences in CIS risk between enrollees and matched controls for low education status (55.6% vs. 35.2%), hypertension (34.7% vs. 26.8%), obesity (59.3% vs. 44.4%), physical inactivity (29.4% vs. 23.6%), smoking (32.8% vs. 14.8%) and heavy alcohol use (13.7% vs 6.7%).
The strongest associations between smoking and CIS risk were among those who smoked at least 20 packs a year (OR = 4.3; 95% CI, 2.1-8.81), men (OR = 6.97; 95% CI, 2.58-18.82), as well as those aged 45 to 49 years (OR = 4.91; 95% CI, 1.74-13.85).
“Our findings suggest that continued public health efforts around preventing smoking, especially heavy smoking, may be an important way to help reduce the number of strokes happening to young people,” Ferdinand said in a related press release.
Reference:
Is smoking tied to unexplained stroke in younger adults? https://www.aan.com/PressRoom/Home/PressRelease/5234. Published Feb. 19, 2025. Accessed Feb. 19, 2025.