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Risk Factors of Ischemic Stroke in Young Adults: A Chinese Single-Center Study
Mingyu Tang1, Guangsong Han1, Ming Yao1
1Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
The International Pediatric Stroke Study (IPSS) classification helps identify risk factors for ischemic stroke in young adults. Atherosclerosis is common in older young adults and men, while chronic conditions affect younger adults and women.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Background:
- Ischemic stroke in young adults presents unique etiological and risk factor profiles distinct from older populations.
- Current etiological classifications are often tailored for older adults, creating diagnostic challenges for younger patients.
- Understanding specific risk factors in young adults is crucial for accurate diagnosis and targeted prevention strategies.
Purpose of the Study:
- To adapt and apply the International Pediatric Stroke Study (IPSS) risk factor categorization to young adult ischemic stroke patients in China.
- To delineate the risk factor profiles of young Chinese adults experiencing their first ischemic stroke.
- To investigate age and sex-specific differences in the distribution of these risk factors.
Main Methods:
- A single-center retrospective study included 538 patients aged 18-50 with a first-ever ischemic stroke.
- Risk factors were collected and categorized using a modified IPSS criteria.
- Statistical analysis explored differences based on age groups (<35 vs. ≥35 years) and sex.
Main Results:
- 93.3% of patients had at least one identified IPSS risk factor.
- Atherosclerosis-related factors were most prevalent (61.7%), followed by prothrombotic states (27.3%) and chronic systemic conditions (24.7%).
- Chronic systemic conditions were more common in younger adults (<35) and women, while atherosclerosis-related factors predominated in older young adults (≥35) and men.
Conclusions:
- The modified IPSS classification system shows promise for characterizing risk factors in young adult ischemic stroke.
- Identifying distinct risk factor patterns based on age and sex is essential for tailored management of stroke in young individuals.
- Further validation of the IPSS criteria in diverse young adult populations is warranted.
Introduction:
The etiology and risk factor profile of ischemic stroke in young adults are different from those in older patients. However, current etiological classifications are more applicable for the older adults, posing a challenge to the diagnosis of young patients with ischemic stroke. In this study, we applied a modified risk factor categorization previously used in the International Pediatric Stroke Study (IPSS) to describe the risk factor profiles of Chinese young patients with ischemic stroke and explore the sex and age differences in the distribution of risk factors.
Methods:
This is a single-center retrospective study. Patients aged 18-50 years with a first-ever ischemic stroke admitted to the Peking Union Medical College Hospital between 2013 and 2020 were consecutively included. The risk factors of patients were collected and divided into 10 categories according to the modified IPSS criteria and the sex and age differences were explored.
Results:
A total of 538 patients were enrolled in this study. The median age was 39 years and 62.6% were men. At least one IPSS risk factor category was identified in the 93.3% of all patients. The most common IPSS subtype was atherosclerosis-related risk factors (61.7%), followed by prothrombotic states (27.3%), chronic systemic conditions (24.7%), arteriopathy (16.2%), and cardiac disorders (10.4%). Chronic systemic conditions were more prevalent in patients aged <35 years (34.0 vs. 19.6%, p < 0.05) and women (43.3 vs. 13.6%, p < 0.0001). Atherosclerosis-related risk factors were more dominant in patients aged ≥35 years (72.6 vs. 41.9%, p < 0.0001) and men (77.2 vs. 35.8%, p < 0.0001).
Conclusions:
The IPSS classification might be a potential tool to better identify the risk factors of ischemic stroke in young adults.
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