Abstract Details

Title Clinical and Diagnostic Characteristics of Stroke in Young Adults in the TAPESTRY Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 14-005

Objective To describe the clinical and diagnostic characteristics of ischemic and hemorrhagic strokes in young adults.

Background The rising incidence of stroke and vascular risk factors in young adults poses a significant public health concern. Despite well-defined guidelines for pediatric and older populations, there is a lack of evidence-based recommendations for young adults. Particularly in the United States, the paucity of clinically descriptive studies in this population limits our understanding of risk factors and stroke mechanisms that guide prevention and management.

Design/Methods This was a retrospective study of young adults diagnosed with a stroke between the ages of 18-55 years. Data were sourced from the Mayo Clinic TAPESTRY database, a research program conducting whole exome sequencing for 100,000 participants. Participants were identified with ICD codes. Chart review yielded demographics, clinical characteristics, and diagnostic data. Descriptive statistics were used for all analyses.

Results In total, 406 young stroke participants were identified (mean age 39.9 years, 71.7% female, 90.6% Caucasian). Common comorbidities were obesity (31.5%), hyperlipidemia (43.2%), hypertension (39.7%), and migraine (48.1%). Using TOAST classification for 363 ischemic strokes, 20 were large artery atherosclerosis, 58 cardioembolic, 10 small vessel disease, 165 undetermined, and 148 other determined etiologies. Of the other etiologies, most were patent foramen ovale (n=58), dissection (n=50), or hypercoagulable state (n=48). Several patients had multiple etiologies. Of the 43 intracerebral hemorrhages, there were 6 aneurysmal, 6 arteriovenous malformation, 6 hemorrhagic transformations, 3 traumas, 2 substance abuse, and 20 undetermined.

Conclusions In our cohort, 46% of strokes had an undetermined etiology. Our data showed themes that overlapped with analyses in pediatric and older adult studies, emphasizing the complexities of stroke in young adults. Further, despite rarely identified atherosclerotic mechanisms, modifiable vascular risk factors were common. More research is needed on the clinical profiles of this unique population to assess risks and inform clinical practice.

Authors/Disclosures
Gyanendra Kumar, MD, FAAN (Mayo Clinic) PRESENTER	Dr. Kumar has received personal compensation in the range of $500-$4,999 for serving as a Medical Consultant with Arizona Medical Board.
Samantha Brown, MD	Ms. Brown has nothing to disclose.
Alexandria C. Vernon, PA (Mayo - phoenix)	Ms. Vernon has received personal compensation for serving as an employee of CND Life Sciences .
Mariah Schroeder	Ms. Schroeder has nothing to disclose.
William A. Libling	Mr. Libling has nothing to disclose.
Brenna C. Beezhold	Ms. Beezhold has nothing to disclose.
Robert Vierkant, MS	Mr. Vierkant has nothing to disclose.
Tony Luehrs, MS	Mr. Luehrs has nothing to disclose.
Hugues Sicotte, PhD	An immediate family member of Dr. Sicotte has stock in Fastenal.
Jan Egan, PhD	Dr. Egan has nothing to disclose.
Konstantinos Lazaridis (Mayo Clinic)	No disclosure on file

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