Observational studyStroke2025
Burden of Modifiable Risk Factors in Young-Onset Cryptogenic Ischemic Stroke by High-Risk Patent Foramen Ovale.
Observational study in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01934725 (Searching for Explanations for Cryptogenic Stroke in the Young), which is not on this map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO)
Who cites it
12 citing papers in PubMed.
- A qEEG-based prognostic model for cognitive impairment after ischemic stroke: Development and internal validation.IBRO neuroscience reports · 2026Article
- Association Between Recent Mechanical Risk Factors for Venous Thrombosis and Young-Onset Cryptogenic Ischemic Stroke.Stroke · 2026Article
- Patent Foramen Ovale: Epidemiology, Risk Factors, Pathophysiology, Clinical Features, Diagnosis, and Management.MedComm · 2026Review
- Diagnostic Yield of Comprehensive Etiologic Evaluation in Young Adults with Ischemic Stroke: Toward a Phenotype-Driven Approach.Journal of clinical medicine · 2026Article
- The mediating role of inflammation and nutrition metabolism in the methylmalonic acid-stroke association.Clinics (Sao Paulo, Brazil) · 2026Article
- Cardiac Organ Damage in Young Adults with Cryptogenic Ischaemic Stroke: The SECRETO Study.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Article
- Article
- Comparing Clinical Characteristics and Outcomes of Tenecteplase Versus Alteplase in Young Adult Patients With Stroke: A Secondary Analysis of the AcT Trial.Stroke (Hoboken, N.J.) · 2026Article
- ESO annual stroke evidence update 2025.European stroke journal · 2026Review
- Subclinical Brain Lesions in Magnetic Resonance Imaging are a Potential Indicator of Patent Foramen Ovale Related Migraines in Younger Patients.Reviews in cardiovascular medicine · 2025Article
- Association between glymphatic dysfunction and cryptogenic stroke risk in patients with patent foramen ovale: a retrospective cross-sectional study.Frontiers in neurology · 2025Article
- Predictive value of patent foramen ovale diameter for cryptogenic stroke and age-related differences.Frontiers in cardiovascular medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
44 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe incidence of young-onset ischemic stroke is rising, driven by cryptogenic ischemic stroke (CIS) and patients without vascular risk factors. This study examines the burden and associations of modifiable traditional, nontraditional, and female sex-specific risk factors with young-onset CIS, stratified by clinically relevant patent foramen ovale (PFO), defined by high-risk features of atrial septal aneurysm or large right-to-left shunt.
methodsWe enrolled consecutive patients aged 18 to 49 years with recent CIS and frequency-matched stroke-free controls of the same age and sex from 19 European sites. Logistic regression assessed the association of risk factor counts (12 traditional, 10 nontraditional, 5 female sex-specific) and individual risk factors, stratified by PFO. Analyses were stratified by sex and age (18-39 and 40-49 years), with computation of population-attributable risk.
resultsWe included 523 patients (median age, 41 years; 47.3% women; 196 [37.5%] with PFO) and 523 controls. In patients with CIS without PFO, each additional traditional (odds ratio, 1.417 [95% CI, 1.282-1.568]), nontraditional (odds ratio, 1.702 [95% CI, 1.338-2.164]), and female sex-specific risk factor (odds ratio, 1.700 [95% CI, 1.107.1-2.611]) increased CIS risk. For patients with CIS with PFO, each traditional risk factor increased the risk (odds ratio, 1.185 [1.057-1.328]), but only nontraditional risk factors remained significant when fully adjusted (odds ratio, 2.656 [2.036-3.464]). Population-attributable risks for CIS without PFO were 64.7%, 26.5%, and 18.9% for traditional, nontraditional, and female sex-specific risk factors. For CIS with PFO, population-attributable risks were 33.8%, 49.4%, and 21.8%, respectively. Migraine with aura was the most significant contributor, with population-attributable risks of 45.8% for CIS with PFO and 22.7% for CIS without PFO, showing a stronger impact in women.
conclusionsDespite the initial cryptogenic label of these strokes, traditional risk factors significantly contribute to CIS without PFO, while nontraditional factors seem more critical for CIS with PFO. Migraine with aura plays a prominent role in young-onset CIS development, particularly in women. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01934725.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.