Smoking Linked to Twofold Higher Risk for Ischemic Stroke

TOPLINE:

Smoking was associated with a doubling in risk for cryptogenic ischemic stroke (CIS), with the strongest association in men and those aged 45-49 years in a new study.

METHODOLOGY:

• In a prospective case-control study, 546 patients with CIS (47% women) aged 18-49 years from 19 European stroke centers were assessed between 2013 and 2022.
• One sex-matched and age-matched (± 5 years) stroke-free control participant was included for each enrolled patient.
• Participants completed standardized questionnaires that collected data on tobacco use, intensity of use, socioeconomic status, and comorbidities.

TAKEAWAY:

• Patients with CIS significantly differed from control individuals in several risk factors including smoking (32.8% vs 14.8%; P < .001).
• After adjusting for confounders, smoking was linked to an increased risk for young CIS (odds ratio [OR], 2.4; P < .001) for the entire cohort, and especially in men (OR, 3.3; P < .05).
• Although this association was found in all age groups, it was highest in those aged 45-49 years (OR, 3.8; P < .05).
• The strongest association with CIS was in high-intensity smokers (> 20 pack-years) (OR, 4.3; P < .0001), particularly in men (OR, 7.0) and in those aged 45-49 years (OR, 4.9).

IN PRACTICE:

“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,” lead author Phillip Ferdinand, MBChB, MRCP, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, England, said in a press release.

SOURCE:

This study was published online on February 19 in Neurology Open Access.

LIMITATIONS: 

The study population was predominantly White European individuals (94%), which limited the generalizability of the findings. Neurologic deficits among patients were relatively mild, leaving uncertainty about the effect of those with more severe strokes on the analysis. In addition, the association between higher smoking intensities and CIS was difficult to observe in those aged 18-34 years because of their small number and the challenge of reaching high pack-years at a younger age. Finally, information on environmental or second-hand smoking exposure was not collected and there were potential reporting and selection biases.

DISCLOSURES:

This study was funded by the Helsinki and Uusimaa Hospital District, Academy of Finland, University of Helsinki, and Sahlgrenska University Hospital. The investigators reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.