Analysis of Ischemic stroke risk factors in young Adults

Authors

  • Ahmed Kawa Fathi M.B.Ch.B, Trainee at Kurdistan higher council of Medical Specialties/Clinical neurology, Rizgary Teaching Hospital - Erbil - Kurdistan region/Iraq
  • Abdulrahman Aziz Rasoul M.B.Ch.B, F.I.B.M.S Neurology, Fellow Of Iraqi Board Of Medical Specialties (neurology), Consultant neurologist, Rizgary Teaching Hospital –Erbil-Kurdistan region/Iraq

DOI:

https://doi.org/10.56056/amj.2023.227

Keywords:

Erbil city, Stroke, Young

Abstract

Background and objectives: Keeping in mind stroke is the leading cause of disability globally, with increasing incidence of Ischemic stroke in young age reaching approximately more than 5-10 % according to multiple studies worldwide especially in developing countries.

Methods: This observational cross-sectional study was conducted at the Neurology Department of the Rizgary Hospital, Erbil, Iraq over 12 months from July 2020 until July 2021. We included consecutive patients whom their age was between 18-45 years with first-ever ischemic stroke fulfilling the definition of The American Stroke Association. All patients underwent thorough history and clinical examination. Each patient underwent routine stroke assessment, including full blood workup and vascular imaging.

Results: Out of 70 patients, 41 (58.8%) were males and 29 (41.4%) were females. There is a male predominance over females, which is comparable with other studies. Our present study showed that the most obvious risk factor for stroke in young people was hypertension, which was present in (38.6%) of cases followed by diabetes mellitus (20 %.), obesity (17.1%), smoking (17%), alcohol consumption (11.4%). Regarding stroke subtypes; small vessel disease was the commonest, subtype, it was present in 25.7% of cases. A stroke from a cardiac source is the second most common (24.3%). About (17.1%) of cases were in the large vessel category. The cause of the stroke was undetermined in (14.5 %) percent of cases (cryptogenic).

Conclusion: Our study demonstrated that traditional atherosclerotic risk factors such as hypertension, diabetes, dyslipidemia, and smoking are responsible for most cases in young adults.

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References

Sacco RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the J. Am. Heart Assoc.Stroke. 2013; 44(7):2064-89.

Chandana V, Kalyani N. Clinical profile of stroke among young adults. Int. j. contemp. med. res. 2017; 4(11):2280-3.

Ekker MS, Boot EM, Singhal AB, et al. Epidemiology, aetiology, and management of ischaemic stroke in young adults. Lancet Neurol. 2018; 17(9):790-801.

Tan KS, Navarro JC, Wong KS, et al. Clinical profile, risk factors and aetiology of young ischaemic stroke patients in Asia: A prospective, multicentre, observational, hospital-based study in eight cities Neurol. Asia. 2014; 19(2): 117-127.

Van Alebeek ME, Arntz RM, Ekker MS, et al. Risk factors and mechanisms of stroke in young adults: The FUTURE study. J Cereb Blood Flow Metab. 2018; 38(9):1631-41.

Patel UK, Dave M, Lekshminarayanan A, et al. Risk Factors and Incidence of Acute Ischemic Stroke: A Comparative Study between Young Adults and Older Adults. Cureus. 2021; 13(4):e14670.

Nencini P, Inzitari D, Baruffi M, et al. Incidence of stroke in young adults in Florence, Italy. Stroke. 1988; 19(8):977-81.

Marini C, Russo T, Felzani G. Incidence of stroke in young adults: a review. Stroke research and treatment. 2010; 2011 (535672): 1-5.

Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P, Van Dijk EJ, de Leeuw F-E. Ischaemic stroke in young adults: risk factors and long-term consequences. Nat. Rev. Neurol. 2014; 10(6):315-25.

Maaijwee NA, Rutten-Jacobs LC, Arntz RM, et al. Long-term increased risk of unemployment after young stroke: a long-term follow-up study. Neurology. 2014; 83(13):1132-8.

Bardugo A, Fishman B, Libruder C, et al. Body mass index in 1.9 million adolescents and stroke in young adulthood. Stroke. 2021; 52(6):2043-52.

Rosman L, Sico JJ, Lampert R, et al. Posttraumatic stress disorder and risk for stroke in young and middle-aged adults: A 13-year cohort study. Stroke. 2019; 50(11):2996-3003.

Singhal AB, Biller J, Elkind MS, et al. Recognition and management of stroke in young adults and adolescents. Neurology. 2013; 81(12):1089-97.

Ferro JM, Massaro AR, Mas J-L. Aetiological diagnosis of ischaemic stroke in young adults. The Lancet Neurol. 2010;9(11):1085-96.

Kissela BM, Khoury JC, Alwell K, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology. 2012; 79(17):1781-7.

Putaala J, Metso AJ, Metso TM, et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke. 2009; 40(4):1195-203.

Fonseca AC, Ferro JM. Drug abuse and stroke. Curr Neurol Neurosci Rep.2013; 13(2):1-9.

Eapen RP, Parikh JH, Patel NT A study of clinical profile and risk factors of cerebrovascular stroke Guj Med J 2009;64(2):47-54.

Yesilot Barlas N, Putaala J, Waje?Andreassen U, et al. Etiology of first?ever ischaemic stroke in European young adults: the 15 cities young stroke study. Eur. J. Neurol. 2013; 20(11):1431-9.

Maqbul A, Nasser W, Salhi AA, et al. Risk Factors of Stroke among Young Adults in KSA. Egypt. J. Hosp. Med. 2018; 70(10):1773-7.

Carretero OA, Oparil S. Essential hypertension: part I: definition and etiology. Circulation. 2000; 101(3):329-35.

Kerner W, Brückel J. Definition, classification and diagnosis of diabetes mellitus. Exp. Clin. Endocrinol.2014;122(07):384-6.

Halawani AF, Alahmari ZS, Asiri DA, Albraheem AA, Alsubaie AM, Alqurashi AG, et al. Diagnosis and Management of Dyslipidemia. Arch. Pharm. Pract.2019; 10(4):67-70.

Adams Jr HP, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993; 24(1):35-41.

Kapoor D, Dhiman A, Sharma R, Sundar S. Clinical profile, risk factors and aetiology of young stroke: a tertiary care hospital based study from the Sub-Himalayan region in North India, Int. j. res. med. sci. technol. 2014; 2 (4): 1355-1359.

Chandrashekar G, Reddy AH. Etiology and Risk Factors of Stroke in Young: A Prospective StudyInt. J. Sci. Study. 2016; 4(7):79-83.

Dalal P. Strokes in Young and elderly; risk factors and strategies for stroke prevention. J Assoc Phys India. 1997; 45:125-31.

Onwuchekwa A, Onwuchekwa R, Asekomeh E. Stroke in young Nigerian adults J. Vasc. Nurs. 2009; 27(4):98-102.

Gray N, Hill D. Patterns of tobacco smoking in Australia. Med J Aust.1975; 2(22):819-22.

Bevan H, Sharma K, Bradley W. Stroke in young adults. Stroke. 1990; 21(3):382-6.

Hillbom M, Kaste M. Ethanol intoxication: a risk factor for ischemic brain infarction. Stroke. 1983; 14(5):694-9.

Tziomalos K, Athyros VG, Karagiannis A, Mikhailidis DP. Dyslipidemia as a risk factor for ischemic stroke. Curr Top Med Chem. 2009; 9(14):1291-7.

Letra L, Sena C. Cerebrovascular disease: consequences of obesity-induced endothelial dysfunction. Obesity and Brain Function. 2017:163-89.

Mitchell AB, Cole JW, McArdle PF, et al. Obesity increases risk of ischemic stroke in young adults. Stroke. 2015; 46(6):1690-2.

Hamza N, Sassi SB, Nabli F, Nagi S, Mahmoud M, Abdelaziz IB, et al. Stroke revealing Neuro-Behçet's disease with parenchymal and extensive vascular involvement. J. Neurol. Sci.2019;398:131-4.

Ji R, Schwamm LH, Pervez MA, Singhal AB. Ischemic stroke and transient ischemic attack in young adults: risk factors, diagnostic yield, neuroimaging, and thrombolysis. JAMA Neurol. 2013; 70(1):51-7.

Schneider S, Kornejeva A, Vibo R, Kõrv J. Risk factors and etiology of young ischemic stroke patients in Estonia. Stroke Res. 2017; 2017 8075697.

Rajbhandari R, Prajuli P, Oli K. Ischemic stroke in young adults: study of the subtypes, risk factors and predictors of poor outcomes. Nepal Journal of Neuroscience. 2019;16(1):29-34.

Siritho S, Thrift A, McNeil J, You R, Davis S, Donnan G. Melbourne Risk Factor Study (MERFS) Group. Risk of ischemic stroke among users of the oral contraceptive pill: The Melbourne Risk Factor Study (MERFS) Group. Stroke. 2003; 34:1575-80.

Chraa M, Louhab N, Kissani N. Stroke in young adults: about 128 cases. Pan Afr. med. 2014; 17(1): 1-7.

Razzaq A, Khan B, Baig S. Ischemic stroke in young adults of South Asia. JPMA. 2002; 52(9):417.

Dash D, Bhashin A, kumar Pandit A, et al. Risk factors and etiologies of ischemic strokes in young patients: a tertiary hospital study in north India. Journal of stroke. 2014; 16(3):173.

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Published

2023-12-05

How to Cite

Fathi, A. K. ., & Rasoul, A. A. . (2023). Analysis of Ischemic stroke risk factors in young Adults. AMJ (Advanced Medical Journal) , 8(2), 136-144. https://doi.org/10.56056/amj.2023.227

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