Age of onset of cerebral venous thrombosis: the BEAST study

Redoy Ranjan; Gie Ken-Dror; Ida Martinelli; Elvira Grandone; Sini Hiltunen; Erik Lindgren; Maurizio Margaglione; Veronique Le Cam Duchez; Aude Bagan Triquenot; Marialuisa Zedde; Michelangelo Mancuso; Ynte M. Ruigrok; Brad Worrall; Jennifer J. Majersik; Jukka Putaala; Elena Haapaniemi; Susanna M. Zuurbier; Matthijs C. Brouwer; Serena M. Passamonti; Maria Abbattista; Paolo Bucciarelli; Robin Lemmens; Emanuela Pappalardo; Paolo Costa; Marina Colombi; Diana Aguiar de Sousa; Sofia Rodrigues; Patrícia Canhao; Aleksander Tkach; Rosa Santacroce; Giovanni Favuzzi; Antonio Arauz; Donatella Colaizzo; Kostas Spengos; Amanda Hodge; Reina Ditta; Thang S. Han; Alessandro Pezzini; Jonathan M. Coutinho; Vincent Thijs; Katarina Jood; Turgut Tatlisumak; José M. Ferro; Pankaj Sharma

doi:10.1177/23969873221148267

Age of onset of cerebral venous thrombosis: the BEAST study

Redoy Ranjan, Gie Ken-Dror, Ida Martinelli, Elvira Grandone, Sini Hiltunen, Erik Lindgren, Maurizio Margaglione, Veronique Le Cam Duchez, Aude Bagan Triquenot, Marialuisa Zedde, Michelangelo Mancuso, Ynte M. Ruigrok, Brad Worrall, Jennifer J. Majersik, Jukka Putaala, Elena Haapaniemi, Susanna M. Zuurbier, Matthijs C. Brouwer, Serena M. Passamonti, Maria AbbattistaPaolo Bucciarelli, Robin Lemmens, Emanuela Pappalardo, Paolo Costa, Marina Colombi, Diana Aguiar de Sousa, Sofia Rodrigues, Patrícia Canhao, Aleksander Tkach, Rosa Santacroce, Giovanni Favuzzi, Antonio Arauz, Donatella Colaizzo, Kostas Spengos, Amanda Hodge, Reina Ditta, Thang S. Han, Alessandro Pezzini, Jonathan M. Coutinho, Vincent Thijs, Katarina Jood, Turgut Tatlisumak, José M. Ferro, Pankaj Sharma^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in young adults. We aimed to determine the impact of age, gender and risk factors (including sex-specific) on CVT onset.

METHODS: We used data from the BEAST (Biorepository to Establish the Aetiology of Sinovenous Thrombosis), a multicentre multinational prospective observational study on CVT. Composite factors analysis (CFA) was performed to determine the impact on the age of CVT onset in males and females.

RESULTS: A total of 1309 CVT patients (75.3% females) aged ⩾18 years were recruited. The overall median (IQR-interquartile range) age for males and females was 46 (35-58) years and 37 (28-47) years ( p < 0.001), respectively. However, the presence of antibiotic-requiring sepsis ( p = 0.03, 95% CI 27-47 years) among males and gender-specific risk factors like pregnancy ( p < 0.001, 95% CI 29-34 years), puerperium ( p < 0.001, 95% CI 26-34 years) and oral contraceptive use ( p < 0.001, 95% CI 33-36 years) were significantly associated with earlier onset of CVT among females. CFA demonstrated a significantly earlier onset of CVT in females, ~12 years younger, in those with multiple (⩾1) compared to '0' risk factors ( p < 0.001, 95% CI 32-35 years).

CONCLUSIONS: Women suffer CVT 9 years earlier in comparison to men. Female patients with multiple (⩾1) risk factors suffer CVT ~12 years earlier compared to those with no identifiable risk factors.

Original language	English
Pages (from-to)	344-350
Number of pages	7
Journal	European Stroke Journal
Volume	8
Issue number	1
DOIs	https://doi.org/10.1177/23969873221148267
Publication status	Published - Mar 2023

Keywords

age of onset
cerebral venous sinus thrombosis
Cerebral venous thrombosis
women

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Ranjan, R., Ken-Dror, G., Martinelli, I., Grandone, E., Hiltunen, S., Lindgren, E., Margaglione, M., Le Cam Duchez, V., Bagan Triquenot, A., Zedde, M., Mancuso, M., Ruigrok, Y. M., Worrall, B., Majersik, J. J., Putaala, J., Haapaniemi, E., Zuurbier, S. M., Brouwer, M. C., Passamonti, S. M., ... Sharma, P. (2023). Age of onset of cerebral venous thrombosis: the BEAST study. European Stroke Journal, 8(1), 344-350. https://doi.org/10.1177/23969873221148267

@article{abc42ff1c6b84a5c8c9d3e240262535d,

title = "Age of onset of cerebral venous thrombosis: the BEAST study",

abstract = "BACKGROUND: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in young adults. We aimed to determine the impact of age, gender and risk factors (including sex-specific) on CVT onset.METHODS: We used data from the BEAST (Biorepository to Establish the Aetiology of Sinovenous Thrombosis), a multicentre multinational prospective observational study on CVT. Composite factors analysis (CFA) was performed to determine the impact on the age of CVT onset in males and females.RESULTS: A total of 1309 CVT patients (75.3% females) aged ⩾18 years were recruited. The overall median (IQR-interquartile range) age for males and females was 46 (35-58) years and 37 (28-47) years ( p < 0.001), respectively. However, the presence of antibiotic-requiring sepsis ( p = 0.03, 95% CI 27-47 years) among males and gender-specific risk factors like pregnancy ( p < 0.001, 95% CI 29-34 years), puerperium ( p < 0.001, 95% CI 26-34 years) and oral contraceptive use ( p < 0.001, 95% CI 33-36 years) were significantly associated with earlier onset of CVT among females. CFA demonstrated a significantly earlier onset of CVT in females, ~12 years younger, in those with multiple (⩾1) compared to '0' risk factors ( p < 0.001, 95% CI 32-35 years). CONCLUSIONS: Women suffer CVT 9 years earlier in comparison to men. Female patients with multiple (⩾1) risk factors suffer CVT ~12 years earlier compared to those with no identifiable risk factors.",

keywords = "age of onset, cerebral venous sinus thrombosis, Cerebral venous thrombosis, women",

author = "Redoy Ranjan and Gie Ken-Dror and Ida Martinelli and Elvira Grandone and Sini Hiltunen and Erik Lindgren and Maurizio Margaglione and {Le Cam Duchez}, Veronique and {Bagan Triquenot}, Aude and Marialuisa Zedde and Michelangelo Mancuso and Ruigrok, {Ynte M.} and Brad Worrall and Majersik, {Jennifer J.} and Jukka Putaala and Elena Haapaniemi and Zuurbier, {Susanna M.} and Brouwer, {Matthijs C.} and Passamonti, {Serena M.} and Maria Abbattista and Paolo Bucciarelli and Robin Lemmens and Emanuela Pappalardo and Paolo Costa and Marina Colombi and {Aguiar de Sousa}, Diana and Sofia Rodrigues and Patr{\'i}cia Canhao and Aleksander Tkach and Rosa Santacroce and Giovanni Favuzzi and Antonio Arauz and Donatella Colaizzo and Kostas Spengos and Amanda Hodge and Reina Ditta and Han, {Thang S.} and Alessandro Pezzini and Coutinho, {Jonathan M.} and Vincent Thijs and Katarina Jood and Turgut Tatlisumak and Ferro, {Jos{\'e} M.} and Pankaj Sharma",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by grants awarded to P.S. from the Stroke Association (UK) and the Dowager Countess Eleanor Peel Trust (UK). P.S. was funded by a Department of Health (UK) Senior Fellowship at Imperial College London for part of this study. The cohort of 231 French cases was constituted during a hospital protocol of clinical research approved by the French Ministry of Health; the biological collection was kept and managed by INSERM CIC-CRB 1404, F-76000 Rouen, France. The controls from Belgium were genotyped as part of the SIGN study. R.L. is a senior clinical investigator of FWO Flanders. T.T. is the recipient of funding from the Sigrid Juselius Foundation (Finland), Helsinki University Central Hospital (Finland), Sahlgrenska University Hospital (Sweden) and the University of Gothenburg (Sweden). The Swedish Research Council (2018-02543) and the Swedish Heart and Lung Foundation (20190203) also supported the study. J.M.C. has received funding from the Dutch Thrombosis Foundation. This material results from work supported by resources and the use of facilities at the VA Maryland Health Care System, Baltimore, Maryland, and was also supported in part by the National Institutes of Health (U01NS069208, R01NS105150 and R01NS100178). Publisher Copyright: {\textcopyright} European Stroke Organisation 2023.",

year = "2023",

month = mar,

doi = "10.1177/23969873221148267",

language = "English",

volume = "8",

pages = "344--350",

journal = "European Stroke Journal",

issn = "2396-9873",

publisher = "SAGE Publications Inc.",

number = "1",

}

Ranjan, R, Ken-Dror, G, Martinelli, I, Grandone, E, Hiltunen, S, Lindgren, E, Margaglione, M, Le Cam Duchez, V, Bagan Triquenot, A, Zedde, M, Mancuso, M, Ruigrok, YM, Worrall, B, Majersik, JJ, Putaala, J, Haapaniemi, E, Zuurbier, SM, Brouwer, MC, Passamonti, SM, Abbattista, M, Bucciarelli, P, Lemmens, R, Pappalardo, E, Costa, P, Colombi, M, Aguiar de Sousa, D, Rodrigues, S, Canhao, P, Tkach, A, Santacroce, R, Favuzzi, G, Arauz, A, Colaizzo, D, Spengos, K, Hodge, A, Ditta, R, Han, TS, Pezzini, A, Coutinho, JM, Thijs, V, Jood, K, Tatlisumak, T, Ferro, JM & Sharma, P 2023, 'Age of onset of cerebral venous thrombosis: the BEAST study', European Stroke Journal, vol. 8, no. 1, pp. 344-350. https://doi.org/10.1177/23969873221148267

TY - JOUR

T1 - Age of onset of cerebral venous thrombosis

T2 - the BEAST study

AU - Ranjan, Redoy

AU - Ken-Dror, Gie

AU - Martinelli, Ida

AU - Grandone, Elvira

AU - Hiltunen, Sini

AU - Lindgren, Erik

AU - Margaglione, Maurizio

AU - Le Cam Duchez, Veronique

AU - Bagan Triquenot, Aude

AU - Zedde, Marialuisa

AU - Mancuso, Michelangelo

AU - Ruigrok, Ynte M.

AU - Worrall, Brad

AU - Majersik, Jennifer J.

AU - Putaala, Jukka

AU - Haapaniemi, Elena

AU - Zuurbier, Susanna M.

AU - Brouwer, Matthijs C.

AU - Passamonti, Serena M.

AU - Abbattista, Maria

AU - Bucciarelli, Paolo

AU - Lemmens, Robin

AU - Pappalardo, Emanuela

AU - Costa, Paolo

AU - Colombi, Marina

AU - Aguiar de Sousa, Diana

AU - Rodrigues, Sofia

AU - Canhao, Patrícia

AU - Tkach, Aleksander

AU - Santacroce, Rosa

AU - Favuzzi, Giovanni

AU - Arauz, Antonio

AU - Colaizzo, Donatella

AU - Spengos, Kostas

AU - Hodge, Amanda

AU - Ditta, Reina

AU - Han, Thang S.

AU - Pezzini, Alessandro

AU - Coutinho, Jonathan M.

AU - Thijs, Vincent

AU - Jood, Katarina

AU - Tatlisumak, Turgut

AU - Ferro, José M.

AU - Sharma, Pankaj

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by grants awarded to P.S. from the Stroke Association (UK) and the Dowager Countess Eleanor Peel Trust (UK). P.S. was funded by a Department of Health (UK) Senior Fellowship at Imperial College London for part of this study. The cohort of 231 French cases was constituted during a hospital protocol of clinical research approved by the French Ministry of Health; the biological collection was kept and managed by INSERM CIC-CRB 1404, F-76000 Rouen, France. The controls from Belgium were genotyped as part of the SIGN study. R.L. is a senior clinical investigator of FWO Flanders. T.T. is the recipient of funding from the Sigrid Juselius Foundation (Finland), Helsinki University Central Hospital (Finland), Sahlgrenska University Hospital (Sweden) and the University of Gothenburg (Sweden). The Swedish Research Council (2018-02543) and the Swedish Heart and Lung Foundation (20190203) also supported the study. J.M.C. has received funding from the Dutch Thrombosis Foundation. This material results from work supported by resources and the use of facilities at the VA Maryland Health Care System, Baltimore, Maryland, and was also supported in part by the National Institutes of Health (U01NS069208, R01NS105150 and R01NS100178). Publisher Copyright: © European Stroke Organisation 2023.

PY - 2023/3

Y1 - 2023/3

N2 - BACKGROUND: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in young adults. We aimed to determine the impact of age, gender and risk factors (including sex-specific) on CVT onset.METHODS: We used data from the BEAST (Biorepository to Establish the Aetiology of Sinovenous Thrombosis), a multicentre multinational prospective observational study on CVT. Composite factors analysis (CFA) was performed to determine the impact on the age of CVT onset in males and females.RESULTS: A total of 1309 CVT patients (75.3% females) aged ⩾18 years were recruited. The overall median (IQR-interquartile range) age for males and females was 46 (35-58) years and 37 (28-47) years ( p < 0.001), respectively. However, the presence of antibiotic-requiring sepsis ( p = 0.03, 95% CI 27-47 years) among males and gender-specific risk factors like pregnancy ( p < 0.001, 95% CI 29-34 years), puerperium ( p < 0.001, 95% CI 26-34 years) and oral contraceptive use ( p < 0.001, 95% CI 33-36 years) were significantly associated with earlier onset of CVT among females. CFA demonstrated a significantly earlier onset of CVT in females, ~12 years younger, in those with multiple (⩾1) compared to '0' risk factors ( p < 0.001, 95% CI 32-35 years). CONCLUSIONS: Women suffer CVT 9 years earlier in comparison to men. Female patients with multiple (⩾1) risk factors suffer CVT ~12 years earlier compared to those with no identifiable risk factors.

AB - BACKGROUND: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in young adults. We aimed to determine the impact of age, gender and risk factors (including sex-specific) on CVT onset.METHODS: We used data from the BEAST (Biorepository to Establish the Aetiology of Sinovenous Thrombosis), a multicentre multinational prospective observational study on CVT. Composite factors analysis (CFA) was performed to determine the impact on the age of CVT onset in males and females.RESULTS: A total of 1309 CVT patients (75.3% females) aged ⩾18 years were recruited. The overall median (IQR-interquartile range) age for males and females was 46 (35-58) years and 37 (28-47) years ( p < 0.001), respectively. However, the presence of antibiotic-requiring sepsis ( p = 0.03, 95% CI 27-47 years) among males and gender-specific risk factors like pregnancy ( p < 0.001, 95% CI 29-34 years), puerperium ( p < 0.001, 95% CI 26-34 years) and oral contraceptive use ( p < 0.001, 95% CI 33-36 years) were significantly associated with earlier onset of CVT among females. CFA demonstrated a significantly earlier onset of CVT in females, ~12 years younger, in those with multiple (⩾1) compared to '0' risk factors ( p < 0.001, 95% CI 32-35 years). CONCLUSIONS: Women suffer CVT 9 years earlier in comparison to men. Female patients with multiple (⩾1) risk factors suffer CVT ~12 years earlier compared to those with no identifiable risk factors.

KW - age of onset

KW - cerebral venous sinus thrombosis

KW - Cerebral venous thrombosis

KW - women

UR - http://www.scopus.com/inward/record.url?scp=85146097582&partnerID=8YFLogxK

U2 - 10.1177/23969873221148267

DO - 10.1177/23969873221148267

M3 - Article

C2 - 37021156

AN - SCOPUS:85146097582

SN - 2396-9873

VL - 8

SP - 344

EP - 350

JO - European Stroke Journal

JF - European Stroke Journal

IS - 1

ER -

Age of onset of cerebral venous thrombosis: the BEAST study

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