{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:32:17Z","timestamp":1783571537863,"version":"3.55.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The aim of this study was to assess the association between endothelial function and early\u2010onset cryptogenic ischemic stroke (CIS), with subgroup analyses stratified by sex and age groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We prospectively enrolled 136 consecutive patients aged 18 to 49\u00a0years (median age, 41\u00a0years; 44% women) with a recent CIS and 136 age\u2010 and sex\u2010matched (\u00b15\u00a0years) stroke\u2010free controls. Endothelial function was measured with an EndoPAT 2000 device and analyzed as tertiles of natural logarithm of reactive hyperemia index with lower values reflecting dysfunction. We used conditional logistic regression adjusting for age, education, hypertension, diabetes mellitus, dyslipidemia, current smoking, heavy drinking, obesity, and diet score to assess the independent association between endothelial function and CIS. Patients in the lowest tertile of natural logarithm of reactive hyperemia index were more often men and they more frequently had a history of dyslipidemia; they were also more often obese, had a lower diet score, and lower high\u2010density lipoprotein cholesterol. In the entire cohort, we found no association in patients with endothelial function and CIS compared with stroke\u2010free controls. In sex\u2010 and age\u2010specific analyses, endothelial dysfunction was associated with CIS in men (adjusted odds ratio [OR], 3.50 for lowest versus highest natural logarithm of reactive hyperemia index tertile; 95% CI, 1.22\u201310.07) and in patients \u226541\u00a0years (OR, 5.78; 95% CI, 1.52\u201321.95). These associations remained significant when dyslipidemia was replaced with the ratio of total to high\u2010density lipoprotein cholesterol.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Endothelial dysfunction appears to be an independent player in early\u2010onset CIS in men and patients approaching middle age.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.020838","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T10:07:05Z","timestamp":1625566025000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Endothelial Dysfunction is Associated With Early\u2010Onset Cryptogenic Ischemic Stroke in Men and With Increasing 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