The Distribution Of Risk Factors For Ischemic Stroke In Young Adults And Its Relationship With Prognosis

Background and objectives In recent years,the incidence and prevalence of ischemic stroke(IS)in young adults has gradually increased,placing a heavy burden on individuals,families and society.Previous studies have found that the main causes were the increased prevalence of traditional vascular risk factors such as hypertension,lipid metabolism,diabetes,smoking,and heart disease among young people.And these traditional vascular risk factors may be related to the patient’s short-term prognosis,stroke recurrence and death events.Previous studies on the distribution of traditional vascular risk factors in young adults and their association with prognosis have varied.This study analyzed the clinical data of young adults with ischemic stroke in our hospital.The purpose is to explore the general characteristics,the etiological classification of TOAST,the distribution of traditional vascular risk factors in different age groups and different genders of ischemic stroke in young adults and their correlation with prognosis,to provide guidance for the primary and secondary prevention of ischemic stroke in young adults,and reduce the incidence and disability.Methods Dada was retrospective reviewed of data from patients aged 18–49 years consecutively treated for first-ever ischemic stroke in department of neurology,First Affiliated Hospital of Zhengzhou University.We analyzed the overall distribution of the traditional vascular risk factors for ischemic stroke and the etiological typing in youth.Patients were then divided into groups according to age and sex,the distribution of traditional vascular risk factors in young people of different genders and different age groups was explored.Patients were divided into well-prognosis group and poor-prognosis group according to MRS scores.Logistic regression analysis was used to analyze the effects of traditional vascular risk factors and severity of onset on short-term prognosis of ischemic stroke in young adults.Results A total of 124 young ischemic stroke patients were included in the study,including 94 males(75.8%),and the incidence increased significantly after 40 years old.The common traditional vascular risk factors for ischemic stroke in young adults are hypertension 55.6%,smoking history 43.5%,hyperlipidemia 41.1%,hyperhomocysteinemia 29%,drinking history 25.8%,and diabetes 22.6%.The effective control of hypertension and diabetes were poor,the effective control rate of hypertension was 17.4%,and diabetes was 10.7%.The etiology of TOAST was classified as 1arge artery atherosclerosis 50.81%,cardioembolism 3.23%,small-artery occlusion 11.29%,other determined etiological 10.48%,and undetermined etilogy 24.19%.Ischemic stroke in young adults mostly affects the pre-circulatory circulation(71.8%).The general symptoms were mild at the time of onset and the prognosis were relatively good.The NIHSS score which was less than 4 points accounted for 67.7%,and the one-month discharge of MRS score which was less than 2 points accounted for 60.4%.The common risk factors in the male population were hypertension(57.4%),smoking history(57.4%),and hyperlipidemia(47.9%),which in the female population were hypertension(50.0%),diabetes(30.0%),and heart disease(26.7%).The most common risk factors for the 18-35 years old stroke group were smoking history(43.8%),hyperlipidemia(31.3%),and hyperhomocysteinemia(31.3%),which in the 36-49 years old stroke group were hypertension(60.2%),smoking history(43.5%),and hyperlipidemia(42.6%).Hypertrnsion(P=0.011)and admission NHISS score(P<0.001)were independent risk factors for poor prognosis of ischemic stroke in young adults.The number of traditional vascular risk factors was associated with the etiological classification of IS in young adults,and multiple risk factors(≥2)were prone to result in 1arge artery atherosclerosis stroke(59.6%,P=0.002).Conclusions 1.The common traditional vascular risk factors for ischemic stroke in young adults included hypertension,smoking history,hyperlipidemia,hyperhomocysteinemia,and alcohol consumption.The common etiological classification was 1arge artery atherosclerosis and undetermined etilogy.2.Different gender and age groups of ischemic stroke in young adults had different risk factors.(1)The common risk factors in the male population were hypertension,smoking history,and hyperlipidemia;which in the female population were hypertension,diabetes,and heart disease.(2)The most common risk factors for stroke patients aged 18-35 years were smoking history,hyperlipidemia,and hyperhomocysteinemia.which in the 36-49 years old stroke group were hypertension,smoking history,and hyperlipidemia.3.Traditional vascular risk factors and severity of onset were associated with the prognosis of ischemic stroke in young adults.Hypertension and high admission NHISS scores were independent risk factors for short-term poor prognosis of ischemic stroke in young adults.4.The number of traditional vascular risk factors was related to the etiology of ischemic stroke in young adults.The coexistence of multiple risk factors was prone to result in 1arge artery atherosclerosis stroke.