Abstract 14466: Characterisation of Recent Trends in Cardiovascular Risk Factors in Younger Patients With Ischaemic Stroke

Abstract

Introduction: Strokes in the young are associated with a disproportionately large economic and social impact in addition to their clinical effects. Standard Modifiable Cardiovascular Risk Factors (SMuRFs; hypercholesterolaemia, hypertension, diabetes mellitus and smoking) are key drivers of cardiovascular disease including strokes, however recent temporal trends in the young stroke population have not been characterised. Hypothesis: The proportion of patients with non-SMuRFs are on the rise in a cohort of younger patients with ischaemic stroke/transient ischaemic attack. Methods: Consecutive patients aged <65 years with clinical and/or radiological diagnosis of ischaemic stroke or transient ischaemic attack in a tertiary referral centre (2013-2017) were retrospectively appraised. The demographic and clinical comorbidities of these patients were assessed including their SMuRF profile. The prevalence over time and clinical associations of patients with no SMuRFs were studied and compared to patients with SMuRFs. Results: Of 487 patients (53.49±9.13yrs, 60% men) analysed, 23% did not have SMuRFs. The proportion of “non-SMuRF” patients increased over time (see Figure; p<0.01) and this trend was not influenced by age (p=0.48) or gender (p=0.68). The presence of SMuRFs was not associated with in-hospital outcomes, however patients without SMuRFs were significantly less likely to be discharged on blood pressure (p<0.01) and lipid-lowering therapies (p=0.03). Conclusions: The proportion of young stroke patients without SMuRFs is substantial and has increased over time. Our findings highlight the need for further research to better understand the mechanisms underlying stroke development in this population and whether less risk factor treatment of this population could impact longer term outcomes.