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CPP : Cardiovascular Prevention and Pharmacotherapy

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2 "Ischemic stroke"
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Original Article
Fabry disease screening in young patients with acute ischemic stroke in Korea
Yunjung Choi, Taedong Ok, Kyung-Yul Lee
Cardiovasc Prev Pharmacother. 2023;5(2):54-60.   Published online April 24, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e5
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Abstract PDF
Background
Fabry disease is an X-linked lysosomal storage disorder that results from a mutation in the α-galactosidase A (GLA) gene. It shows multiple organ involvement, including cerebrovascular disease. Since Fabry disease has a prevalence of approximately 4% in young patients with cryptogenic stroke, screening for this condition is recommended for young stroke patients. This study aimed to investigate the prevalence of Fabry disease in young acute ischemic stroke patients in Korea, the distribution of GLA gene mutations, and the subtypes of ischemic stroke.
Methods
This study included 211 young patients with acute ischemic stroke or transient ischemic attack. To screen for Fabry disease, α-galactosidase A (α-Gal A) enzyme activity was measured and DNA sequencing analysis of the GLA gene was performed.
Results
None of the patients exhibited low α-Gal A enzyme activity or had a pathogenic GLA mutation, but 18 nonpathogenic GLA gene variants were detected, including c.-10C>T in 16 patients, c.-33C>T in one patient, and c.196G>C in one patient. The mean α-Gal A enzyme activity in 14 male patients with the c.-10C>T variant was 5.17±1.19, which was significantly lower than that of male patients with the normal genotype (7.47±3.48, P<0.05). The distribution of stroke subtypes in patients with GLA gene polymorphisms was not significantly different from that in patients with a normal genotype.
Conclusions
This study demonstrates that Fabry disease is rare in young patients with ischemic stroke or transient ischemic attack in Korea, and we suggest that routine screening for Fabry disease may not be necessary for ischemic stroke patients.
Review Article
Antiplatelet Therapy for Secondary Stroke Prevention in Patients with Ischemic Stroke or Transient Ischemic Attack
Kyung-Yul Lee
Cardiovasc Prev Pharmacother. 2021;3(4):86-94.   Published online October 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e10
  • 5,834 View
  • 249 Download
Abstract PDF
The risk of stroke recurrence is highest in the acute phase after transient ischemic attack (TIA) or ischemic stroke. Therefore, patients with TIA or ischemic stroke should be treated with antiplatelet medication for stroke prevention. The short-term use of dual antiplatelet therapy between 21 and 90 days may be considered in those with acute minor stroke or TIA and highrisk of recurrence. However, the long-term use of dual antiplatelet therapy is not recommended due to the risk of bleeding. The current stroke guideline does not specify the administration of an antiplatelet for the secondary prevention of ischemic stroke. However, as clinical studies progress, antiplatelet therapy may become a personalized treatment in the future.

CPP : Cardiovascular Prevention and Pharmacotherapy