Abstract Details

Title Associations Between Risk Factors and Stroke Mechanisms in Young Adult Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-012

Objective NA

Background Atherosclerotic stroke risk factors are prevalent among young adults with stroke. However, it is not certain if these risk factors are contributors to the majority of index mechanisms of stroke in young adults.

Design/Methods This retrospective cohort study included young adults age 18-50 with a primary stroke diagnosis (ischemic stroke, IS, transient ischemic attack, TIA, intracerebral hemorrhage, ICH, subarachnoid hemorrhage, SAH) evaluated in inpatient or outpatient settings at a tertiary care academic medical center between 1/2016-12/2017. Covariates included demographics, medical history, stroke subtype, and stroke mechanism. Comparisons were made using the Chi-square, Fisher exact, and t tests.

Results This study included 263 patients (128 women, 135 men). Atherosclerotic risk factors were common among young adults: hypertension (38%), hyperlipidemia (25%), diabetes (20%), tobacco use (47%). Women were more likely to have migraine (34% vs 16%, p=0.001), and men were more likely to be tobacco users (39% vs 54%, p=0.01). Women had more aneurysmal SAH (62% vs 23% hemorrhagic strokes, p<0.001). Men had more hypertensive ICH (3% vs 23% hemorrhagic strokes, p=0.02). When comparing the frequency of atherosclerotic risk factors between young adults with stroke mechanisms commonly implicated with atherosclerosis (e.g. large artery atherosclerosis, LAA, small vessel occlusions, SVO) and unrelated stroke mechanisms, these risk factors were not more frequent in patients with LAA and SVO.

Conclusions

Despite a high prevalence of atherosclerotic risk factors among young adults with stroke in this cohort, only a small proportion of young adults had stroke mechanisms pathogenically related to these risk factors. This observation should prompt further research on risk factors related to non-atherosclerotic mechanisms of stroke in young adults and modification of patient counseling about the role of atherosclerotic risk factors to their index strokes.

Authors/Disclosures
PRESENTER	No disclosure on file
Lester Y. Leung, MD (Tufts Medical Center)	Dr. Leung has received research support from NIH.

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