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Feature Article

Emerging risk factors for stroke

WenWen Zhang, Helen M Dewey, Dominique A Cadilhac, Geoffrey Alan Donnan

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Abstract

Emerging risk factors such as aortic atheroma, patent foramen ovale, thrombophilia and hyperhomocysteinaemia may contribute to the mechanisms or causes of cryptogenic stroke, which currently accounts for 40% of all ischaemic strokes.

Key Points

  • Stroke causes 9% of all deaths worldwide and is the second most common cause of death after ischaemic heart disease. In Australia, about 40,000 to 48,000 stroke events occur each year and stroke is responsible for nearly 7% of all deaths.
  • There are several emerging risk factors for stroke, including aortic arch atheroma, patent foramen ovale, thrombophilia and hyperhomocysteinaemia.
  • Patent foramen ovale may be an important contributor to cryptogenic strokes, particularly in patients aged less than 55 years. There is also a strong relation between severe aortic arch atheroma and stroke.
  • For several of these risk factors, there are still concerns about optimal treatments. Unravelling the relation between stroke and these emerging risk factors may be important for future stroke prevention initiatives.

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