A Family History of Stroke Is Associated with Increased Intima-Media Thickness in Young Ischemic Stroke - The Norwegian Stroke in the Young Study (NOR-SYS)

PLoS One. 2016 Aug 9;11(8):e0159811. doi: 10.1371/journal.pone.0159811. eCollection 2016.


Background and purpose: Positive family history (FH+) of cardiovascular disease (CVD) is a risk factor for own CVD. We aimed to analyze the effect of different types of FH (stroke, coronary heart disease (CHD), peripheral artery disease (PAD) on carotid intima-media thickness (cIMT) in young and middle-aged ischemic stroke patients.

Methods: First-degree FH of CVD was assessed in ischemic stroke patients ≤ 60y using a standardized interview. Carotid ultrasound was performed and far wall cIMT in three carotid artery segments was registered, representing the common carotid (CCA-IMT), carotid bifurcation (BIF-IMT) and the internal carotid artery (ICA-IMT). Measurements were compared between FH+ and FH negative groups and stepwise backward regression analyses were performed to identify factors associated with increased cIMT.

Results: During the study period 382 patients were enrolled, of which 262 (68%) were males and 233 (61%) reported FH of CVD. Regression analyses adjusting for risk factors revealed age as the most important predictor of cIMT in all segments. The association between FH+ and cIMT was modified by age (p = 0.014) and was significant only regarding ICA-IMT. FH+ was associated with increased ICA-IMT in patients aged < 45y (p = 0.001), but not in patients ≥ 45y (p = 0.083). The association with ICA-IMT was present for a FH of stroke (p = 0.034), but not a FH+ of CHD or PAD.

Conclusions: FH of stroke is associated with higher ICA-IMT in young ischemic stroke patients. Subtyping of cardiovascular FH is important to investigate heredity in young ischemic stroke patients.

Trial registration: ClinicalTrials.gov NCT01597453.

MeSH terms

  • Adolescent
  • Adult
  • Brain Ischemia / complications*
  • Carotid Intima-Media Thickness*
  • Family*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Risk Assessment
  • Risk Factors
  • Stroke / complications
  • Stroke / epidemiology*
  • Stroke / physiopathology*
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT01597453

Grant support

University of Bergen funded the PhD scholarship of HØ and KMS. Helse Vest provided the infrastructure needed to perform the study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.