Evidence map›Paper›PMID 40251949›Full record

ArticleInternational journal of stroke : official journal of the International Stroke Society2026

Non-cardiac and cardiac risk for ischemic stroke in young adults: The Stanford Y-CORE (Young Cardiovascular Outcomes and Risk Evaluation) study.

Brototo Deb, Sunil Vasireddi, Neal K Bhatia, Albert J Rogers, Paul Clopton, Paul Heidenreich, Tina Baykaner, Paul J Wang, Alexander C Perino, Sanjiv M Narayan

Abstract read
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Article in International journal of stroke : official journal of the International Stroke Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Young stroke: An update on epidemiology, emerging risk factors, and future research directions.International journal of stroke : official journal of the International Stroke Society · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Brototo DebDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.ORCID 0000-0001-8800-0002
Sunil VasireddiDivision of Cardiovascular Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Neal K BhatiaDepartment of Medicine, Emory University, Atlanta, GA, USA.
Albert J RogersDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.
Paul CloptonDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.
Paul HeidenreichDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.
Tina BaykanerDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.
Paul J WangDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.
Alexander C PerinoDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.
Sanjiv M NarayanDepartment of Medicine, Cardiovascular Institute and Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, USA.

Funding

The Dynamics of Human Atrial FibrillationR01HL083359 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Sanjiv M Narayan · 2008 to 2026
$7.9M
Machine Learning in Atrial FibrillationR01HL149134 · NHLBI · STANFORD UNIVERSITY · PI NARAYAN, SANJIV M · 2020 to 2024
$3.8M
Deep Neural Networks To Treat Atrial FibrillationK23HL145017 · NHLBI · STANFORD UNIVERSITY · PI BAYKANER, TINA · 2019 to 2023
$968k
Electrical Mapping Signatures of Adverse Structural and Functional Remodeling in Ventricular ArrhythmiaK23HL166977 · NHLBI · STANFORD UNIVERSITY · PI Albert Joseph Rogers · 2023 to 2026
$680k
NHLBI NIH HHS K23 HL145017NHLBI NIH HHS K23 HL166977NHLBI NIH HHS R01 HL083359NHLBI NIH HHS R01 HL149134
6 · The paper itself

Abstract

backgroundThe incidence of stroke is increasing in young to middle-aged adults. Assessing risk factors is important in this large population whose comorbidities may differ from older adults.

methodsIn this retrospective cohort analysis of adults aged between 20 and 50 presenting to the Stanford Healthcare system from 1 January 2000 through 31 December 2021, with no prior history of stroke or transient ischemic attack, we studied the effects of 30 risk factors on the primary endpoint of incident ischemic stroke, defined by the presence of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes for stroke and confirmed by brain imaging. The secondary endpoint was incident cerebrovascular events defined by the presence of ICD-10 codes for stroke or transient ischemic attacks (TIAs). Associations were measured with time-varying multivariable survival regression.

resultsFrom an overall population of 1.3 million, we identified 540,999 individuals aged 20-50 years. Over the study period, 802 experienced the primary endpoint and 5734 the secondary endpoint. On multivariable analysis, non-cardiovascular risk factors were independently associated with the primary endpoint, adjusting for established cardiovascular risk factors, including sleep apnea [1.44, (1.19, 1.74)], bipolar disorder [1.88, (1.23, 2.86)], cancer [2.07 (1.71, 2.51)], and chronic kidney disease (CKD) [2.2, (1.73, 2.81)]. Other non-cardiovascular associations included ethno-racial subgroups of Black [2.05, (1.60, 2.64)], Pacific Islander [2.56, (1.70, 3.84)], and Hispanic [1.71, (1.37, 2.15)] versus white non-Hispanics. Combining non-cardiovascular risk factors significant on multivariable analysis with established cardiovascular factors significantly improved the C-index for de novo stroke to 0.814 over that obtained in either group alone (

conclusionsIn this large population of young adults, several non-cardiovascular factors conferred risk for incident stroke independent of known cardiovascular risk factors and, in combination, significantly improved the prediction of incident stroke over those based on either group of factors alone. These findings may have implications for assessing risk in younger patients with distinct comorbidities.

Indexed as

Ischemic StrokeAdultComorbidityFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsYoung AdultanticoagulationAtrial fibrillationracesleep apneastrokeyoung

Identifiers

PMID40251949
PMCPMC12940088

What OpenQuestion holds

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Registered trials

None linked

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.