2023 American Academy of Neurology Abstract Website

Objective:

This study aims to determine significant clinical and genetic factors of AIS recurrence.

Background:

The involvement of thrombotic genetic markers such methylenetetrahydrofolate reductase (MTHFR) polymorphisms (C677T and A1298C), factor V Leiden (FVL), G20210A mutation of prothrombin (PT) and recurrent arterial ischemic stroke (AIS) in adults remains unclear.

Design/Methods:

We investigated a cohort study of AIS patients (18–50 years old) followed in the neurology department over 5 years. Traditional and genetic risk factors were carried out through a multivariable logistic regression model.

Results:

Two hundred and seventy patients were enrolled in our study. The risk of AIS recurrence was 36.2% within 5 years. The potential risk of recurrence of AIS increased with traditional risk factors notably hypertension, diabetes mellitus, heart failure, and family history of cerebrovascular diseases. The TT polymorphism of MTHFR 677 increased 2.4-fold the risk of AIS recurrence (OR: 2.47; 95%CI [1.35–4.53]). Both variants AC and CC of MTHFR 1298 polymorphism were associated with a second ischemic cerebral attack (OR:2.68, 95%CI [1.44–4.90], 6.89, 95%CI [2.35–20.23], respectively). The GA variation of FVL was considered a significant genetic factor increasing the risk of AIS recurrence 2.5-fold (OR: 2.54; 95% CI [1.15–5.61]). But, no significant difference was observed between the two groups concerning PT mutation.

Conclusions:

Our findings suggest that besides traditional risk factors, the MTHFR polymorphisms, and FVL play an important role in increasing the risk of recurrent AIS in young patients.