Acute non-alcoholic caffeinated beverage consumption as a trigger for cryptogenic ischemic stroke in the young: findings from the SECRETO study

Phillip Ferdinand; Ram Bajpai; Bettina von Sarnowski; Pauli Ylikotila; Marialuisa Zedde; Tomi Sarkanen; Kristina Ryliškienė; Nicolas Martinez-Majander; Lauri Tulkki; Radim Licenik; Janika Kõrv; Liisa Kõrv; Alessandro Pezzini; Ana Catarina Fonseca; Patricia Martinez-Sanchez; Laura Amaya-Pascasio; Nilufer Yesilot; Ulrike Waje-Andreassen; Annette Fromm; Juha Huhtakangas; Ulla Junttola; Pekka Jäkälä; Anne-Mari Kantanen; Petra Redfors; Juha Sinisalo; Eva Gerdts; Turgut Tatlisumak; Christine Roffe; Jukka Putaala

doi:10.1007/s00415-026-13882-2

Title	Acute non-alcoholic caffeinated beverage consumption as a trigger for cryptogenic ischemic stroke in the young: findings from the SECRETO study
Authors	Ferdinand, Phillip ; Bajpai, Ram ; von Sarnowski, Bettina ; Ylikotila, Pauli ; Zedde, Marialuisa ; Sarkanen, Tomi ; Ryliškienė, Kristina ; Martinez-Majander, Nicolas ; Tulkki, Lauri ; Licenik, Radim ; Kõrv, Janika ; Kõrv, Liisa ; Pezzini, Alessandro ; Fonseca, Ana Catarina ; Martinez-Sanchez, Patricia ; Amaya-Pascasio, Laura ; Yesilot, Nilufer ; Waje-Andreassen, Ulrike ; Fromm, Annette ; Huhtakangas, Juha ; Junttola, Ulla ; Jäkälä, Pekka ; Kantanen, Anne-Mari ; Redfors, Petra ; Sinisalo, Juha ; Gerdts, Eva ; Tatlisumak, Turgut ; Roffe, Christine ; Putaala, Jukka
DOI	10.1007/s00415-026-13882-2
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Is Part of	Journal of neurology.. Heidelberg : Springer. 2026, vol. 273, iss. 7, art. no. 388, p. [1-9].. ISSN 0340-5354. eISSN 1432-1459
Keywords [eng]	case-crossover analysis ; cryptogenic ischemic stroke ; triggers of ischemic stroke ; young ischemic stroke
Abstract [eng]	Introduction: Cryptogenic ischemic stroke (CIS) is responsible for the increase in young ischemic strokes. We investigated non-alcoholic caffeinated beverages as a trigger for young CIS, in a large multi-center, case–control study. Methods: In Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725), patients 18–49 years old suffering first ever CIS were recruited within 2 weeks of symptom onset. A structured questionnaire obtained information on coffee, tea, and cola consumption in the last 12 months, usual daily consumption, consumption 24 h preceding stroke and timing of the last consumption prior to stroke. Case-crossover analysis was performed using the Mantel–Haenszel method. Results: 598 CIS patients (54.7% male, mean age 39.4 [standard deviation 8.2]) were analyzed. Case-crossover analysis found association with coffee consumption in the 1-h (relative risk [RR] 1.73, 95% confidence interval [CI] 1.06–2.83) and 2-h (RR 2.15, 95%CI 1.40–3.29) hazard periods, tea consumption in the 1-h (RR 3.93, 95%CI 1.04–14.95) and 2- hour (RR 4.89, 95%CI 1.92–12.50) hazard periods and cola consumption (RR 3.70, 95%CI 1.18–11.62) in the 2-h hazard period. Sub-group analysis in the 2-h hazard period found coffee consumption was associated in both sexes and age groups, high-risk patent foramen ovale (PFO), mild/moderate stress and both low-/high-risk factor burden. Tea consumption was associated in both sexes and age groups and those without PFO. Conclusion: Coffee, tea, and cola consumption as potential trigger factors were associated with young CIS patients within the 2-h hazard period, with coffee and tea maintaining association in several sub-groups.
Published	Heidelberg : Springer
Type	Journal article
Language	English
Publication date	2026
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„Acute non-alcoholic caffeinated beverage consumption as a trigger for cryptogenic ischemic stroke in the young: findings from the SECRETO study“