{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:58:34Z","timestamp":1782406714067,"version":"3.54.5"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The incidence of cryptogenic ischemic stroke (CIS) in young adults is increasing, particularly among those without traditional vascular risk factors. Thrombophilia may contribute to CIS pathogenesis, yet guidelines differ on the relevance of screening. We investigated the sex-specific prevalence of routinely applied thrombophilia screening in young-onset CIS and its association with clinical characteristics and standard laboratory results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We included young patients with CIS aged 18 to 49 years from the SECRETO study (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Triggers, Causes, and Outcome). Routinely used thrombophilia panels obtained at admission and repeated testing within 1 year of stroke were analyzed. Ten thrombophilia markers were assessed and categorized according to the grade of deviation into lowest, low, and high thrombosis risks. Factors associated with any deviation in thrombophilia markers were investigated with multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 598 initially enrolled patients with CIS, 556 undergoing baseline thrombophilia testing were analyzed (median age, 41.0 [interquartile range, 34.1\u201345.8] years; male:female ratio 1.2:1). Of these, 120 (21.6%) and 36 (6.5%) were retested by 3 and 12 months, respectively. At baseline, any thrombophilia abnormality was observed in 206 patients (37.1%; men, 38.2%; women, 35.7%). High-risk thrombophilia was identified in 29 patients (5.2%) at baseline, in 13 retested patients (11.1%) at 3 months, and in 5 retested patients (13.9%) at 12 months. Overall, 45 patients (8.1%) had persistent thrombophilia abnormalities (men, 7.9%; women, 8.3%). Physical inactivity, a history of venous thromboembolism, low HDL (high-density lipoprotein)-cholesterol, and low hemoglobin were associated with any deviation in the thrombophilia markers. Anticoagulation was initiated in 50.0% of patients with abnormal baseline thrombophilia versus 35.7% without (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.042) and in 26.9% versus 6.2% with and without persistent abnormalities (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Over a third of young adults with CIS had thrombophilia deviations at admission although high-risk thrombophilia results remained rare. Screening may be considered in young patients with CIS with a history of venous thromboembolism, physical inactivity, and low hemoglobin or HDL-cholesterol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.053251","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T09:00:12Z","timestamp":1773651612000},"page":"1242-1255","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Thrombophilia Screening in Young Patients With Cryptogenic Ischemic Stroke"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4850-9918","authenticated-orcid":true,"given":"Sofie","family":"Abels","sequence":"first","affiliation":[{"name":"Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland."},{"name":"Department of Neurology (S.A.), Radboud University Medical Center, Nijmegen, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0731-8296","authenticated-orcid":true,"given":"Maximillian","family":"Sihvo","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9369-5846","authenticated-orcid":true,"given":"Liisa","family":"Tomppo","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5483-435X","authenticated-orcid":true,"given":"Shakar","family":"Kutal","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8489-7051","authenticated-orcid":true,"given":"Nicolas","family":"Martinez-Majander","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2823-8574","authenticated-orcid":true,"given":"Lauri","family":"Tulkki","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8815-2807","authenticated-orcid":true,"given":"Tomi","family":"Sarkanen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, and Faculty of Medicine and Health Technology, Tampere University, Finland (T. Sarkanen)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8410-6915","authenticated-orcid":true,"given":"Pekka","family":"J\u00e4k\u00e4l\u00e4","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocenter Neurology, Kuopio University Hospital, Finland (P.J.)."},{"name":"University of Eastern Finland, Kuopio (P.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5956-4255","authenticated-orcid":true,"given":"Petra","family":"Redfors","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden (P.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7143-519X","authenticated-orcid":true,"given":"Juha","family":"Huhtakangas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oulu University Hospital and University of Oulu, Finland (J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4126-9666","authenticated-orcid":true,"given":"Pauli","family":"Ylikotila","sequence":"additional","affiliation":[{"name":"Department of Neurology, Turku University Hospital and University of Turku, Finland (P.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1458-476X","authenticated-orcid":true,"given":"Bettina","family":"von Sarnowski","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medicine Greifswald, Germany (B.v.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9655-9487","authenticated-orcid":true,"given":"Nilufer","family":"Yesilot","sequence":"additional","affiliation":[{"name":"Istanbul Faculty of Medicine, Department of Neurology, Istanbul University, Turkey (N.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3240-6040","authenticated-orcid":true,"given":"Ulrike","family":"Waje-Andreassen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Haukeland University Hospital, Bergen, Norway (U.W.-A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6913-5526","authenticated-orcid":true,"given":"Ana Catarina","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Neurology, Hospital de Santa Maria, University of Lisbon, Portugal (A.C.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1945-4435","authenticated-orcid":true,"given":"Patricia","family":"Martinez Sanchez","sequence":"additional","affiliation":[{"name":"Department of Neurology, Torrecardenas University Hospital, University of Almer\u00edaa, Spain (P.M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6074-0727","authenticated-orcid":true,"given":"Janika","family":"K\u00f5rv","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, University of Tartu, Estonia (J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Ferdinand","sequence":"additional","affiliation":[{"name":"Neurosciences, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom (P.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9596-1733","authenticated-orcid":true,"given":"Kristina","family":"Ryliskiene","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center of Neurology, Vilnius University, Lithuania (K.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8629-3315","authenticated-orcid":true,"given":"Alessandro","family":"Pezzini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Department of Emergency, University of Parma and Stroke Care Program, Parma University Hospital, Italy (A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9145-4598","authenticated-orcid":true,"given":"Radim","family":"Licenik","sequence":"additional","affiliation":[{"name":"North West Anglia NHS Foundation Trust, Acute Stroke Centre, Peterborough, United Kingdom (R.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7530-818X","authenticated-orcid":true,"given":"Marialuisa","family":"Zedde","sequence":"additional","affiliation":[{"name":"Neurology Unit, Stroke Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS Reggio EmiliaSanitaria Locale-IRCCS Reggio Emilia, Italy (M.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8691-5142","authenticated-orcid":true,"given":"Mika","family":"Lehto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart and Lung Center (M.L., J.S.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-5137","authenticated-orcid":true,"given":"Juha","family":"Sinisalo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart and Lung Center (M.L., J.S.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4109-2311","authenticated-orcid":true,"given":"Eva","family":"Gerdts","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Center for Research on Cardiac Disease in Women, University of Bergen, Norway (E.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7796-4463","authenticated-orcid":true,"given":"Hugo","family":"Ten Cate","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Center and CARIM School for Cardiovascular Diseases, the Netherlands (H.T.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5273-8088","authenticated-orcid":true,"given":"Tuukka A.","family":"Helin","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, HUS Diagnostic Center (T.A.H., L.J.-K.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7355-2354","authenticated-orcid":true,"given":"Lotta","family":"Joutsi-Korhonen","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, HUS Diagnostic Center (T.A.H., L.J.-K.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7006-6564","authenticated-orcid":true,"given":"T\u00edmea","family":"Sz\u00e1nt\u00f3","sequence":"additional","affiliation":[{"name":"Unit of Coagulation Disorders, Department of Hematology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Finland (T. Sz\u00e1nt\u00f3)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2221-3026","authenticated-orcid":true,"given":"Frank-Erik","family":"de Leeuw","sequence":"additional","affiliation":[{"name":"Radboud Institute for Medical Research and Innovation, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience (F.-E.d.L.), Radboud University Medical Center, Nijmegen, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6630-6104","authenticated-orcid":true,"given":"Jukka","family":"Putaala","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007533"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.1520"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987317703210"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-06-0566"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/10760296211002274"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.123.010307"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/genes13112081"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012877"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023010177"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.32.8.1793"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2021.03.028"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/670138"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58081056"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2018-000169"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000352050"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1159\/000530675"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2012.06480.x"},{"key":"e_1_3_3_19_2","volume-title":"Thrombophilia testing","author":"Laboratories MC","unstructured":"Laboratories MC. Thrombophilia testing. Mayo Clinic Laboratories. Accessed April 4, 2025. https:\/\/news.mayocliniclabs.com\/hematology\/coagulation-disorders\/thrombophilia-testing\/#section1"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac605"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)11058-9"},{"key":"e_1_3_3_22_2","volume-title":"HUS Diagnostic Center","author":"Hospital HHU","unstructured":"Hospital HHU. HUS Diagnostic Center. Accessed April 4, 2025. https:\/\/diagnostiikka.hus.fi"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13045"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2014.927713"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.06.072"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2023.03.009"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.028058"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1159\/000328219"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.529883"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.122.040524"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000046457.54037.cc"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2012.07.020"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.124.049855"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.106.480863"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032360"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.125.053251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:01:03Z","timestamp":1778608863000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.125.053251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1161\/STROKEAHA.125.053251"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.125.053251","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-08-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-18","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}