Cited by 108Acute Ischemic Stroke ManagementCerebrovascular and Carotid Artery DiseasesNeurological and metabolic disorders

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Why now? Moving from stroke risk factors to stroke triggers

Elkind, Mitchell SV·2007·Current Opinion in Neurology

DOI 10.1097/wco.0b013e328012da75

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Abstract

PURPOSE OF REVIEW: While chronic risk factors for stroke are reasonably well understood, the acute precipitants, or triggers, of stroke, remain relatively understudied. RECENT FINDINGS: Several converging lines of evidence indicate that transient perturbations in systemic metabolism may provoke the onset of cardiovascular events, including stroke. Epidemiologic data, including studies utilizing novel designs that consider intraindividual differences across different time periods, have been used to clarify triggers for myocardial ischemia, and these methods are beginning to be employed in stroke research. Acute infections, particularly upper respiratory infections, and other inflammatory stimuli have emerged as important triggers of acute ischemic stroke. The mechanisms involved include immunologically mediated activation of platelets and endothelial dysfunction. There also appears to be a period of time, or 'stroke-prone state', characterized by diffuse activation of the vasculature during which patients may be at increased risk of initial and recurrent ischemic events. SUMMARY: Confirmation of these findings in further studies may help elucidate the mechanisms behind this short-term increase in stroke risk. Improved methods of assessment of this period of heightened susceptibility could lead to more temporally focused preventive interventions.

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Authors: Elkind, M. S.
Affiliations: NewYork–Presbyterian Hospital (US)
Corresponding author: Elkind, Mitchell SV
ORCID: Elkind, Mitchell SV
Venue: Current Opinion in Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2007-02
Volume: 20
Issue: 1
Pages: 51-57
ISSN: 1350-7540 (ISSN-L)
DOI: 10.1097/wco.0b013e328012da75
OpenAlex: W2011140183
Cited by: 108
References: 64
Citations by year: 2026: 4 · 2025: 1 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 24 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 2 · 2015: 5 · 2014: 4 · 2013: 6 · 2012: 3
FWCI: 0.62
Type: journal article
Language: en
Open access: closed
Locations: Current Opinion in Neurology (publishedVersion)
PubMed (publishedVersion)
Funders: American Heart Association
National Institute of Neurological Disorders and Stroke (K23 NS42912, K23NS042912, R01NS048134, R01NS48134)
Topics: Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cerebrovascular and Carotid Artery Diseases
Health Sciences › Medicine › Clinical Neurology › Neurological and metabolic disorders
Keywords: acute ischemic stroke, systemic metabolism, acute infection, upper respiratory tract infection, inflammation, platelet activation, endothelial dysfunction, myocardial ischemia, within-person variability, stroke prevention
MeSH terms: Blood Platelets, Cerebral Arteries, Humans, Infections, Influenza, Human, Risk Factors, Vasculitis, Comorbidity, Stroke, Endothelial Cells

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Why now? Moving from stroke risk factors to stroke triggers

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