Prediction and prevention of ischemic stroke in young people depending on genetic polymorphism using a smartphone application

Background. Every year, the incidence of ischemic stroke (IS) in the Russian Federation is steadily increasing, often affecting people of employable age. At a young age, the typical causes of stroke are much less common than in the general population. A group of young patients suffered from ischemic stroke (IS) needs to be provided with an extended medical examination involving genotyping methods aimed at the development of personalized measures of primary and secondary prevention.

Objective. To use our software developed for mobile devices, which allows us to calculate the risk of IS taking into account the genetic predisposition of the patient thereby to develop a scheme for the pathology prevention.

Materials and methods. The genetic, clinical and laboratory results of 280 patients examination have been analyzed. Group I consisted of patients with IS (n = 180) aged 22 to 45 years (mean age 33.4 ± 6.57, including 38 patients who experienced recurrent IS. Group II included patients with IS (n = 50) aged 52 to 100 years (mean age 73.4 ± 8.24 years). Group III, the control one, consisted of apparently healthy individuals (n = 50) aged 20 to 43 years (mean age 31.5 ± 5.82 years). All patients underwent computed tomography of the brain, ultrasound examination of the brachiocephalic arteries, and echocardiography. Pharmacogenetic investigations as well as venous blood tests were once performed in all the subjects to reveal a genetic predisposition to thrombophilia.

Results. The programme for the Android operating system has been designed which allows calculating the risk of IS development as well as the risk predicting coefficient of the recurrent IS, on the basis of the DNA tests obtained to reveal a genetic predisposition to so called 'vascular catastrophes' (21.10.2020 the programme 'Prediction and individualized prevention of ischemic stroke' was included in the register of computer programmes, registration No. 2020663019). Applying our product, we have implemented a new approach to the secondary prevention in stroke survivors.

Conclusion. The use of remote monitoring devices can dramatically help in the implementation of tailor-made IS prevention programmes. The genetic passport of the patient will make it possible to carry out an adequate pathogenetic therapy and prevention of acute cerebral circulation disorders.

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