Abstract TP183: Characteristics of Stroke in the Young in a Diverse Urban County

Abstract

Introduction: The incidence of acute ischemic stroke (AIS) among the young in the United States has increased by as much as 35% over the past 15 years. To curb this trend, more information is needed on the subtypes and risk factors for AIS in the young. We sought to characterize AIS subtypes in patients aged 19 to 49 in a racially and ethnically diverse urban county. Hypothesis: We hypothesized that race/ethnic minorities would have a younger median age of AIS and more small vessel disease given known disparities in cardiovascular health. Methods: We performed a retrospective cohort study of AIS patients aged 19-49 discharged from two Bronx-based academic teaching hospitals from 2013 to 2018. Strokes were subtyped using TOAST criteria. ANOVA and Mann-Whitney U-tests were used to determine age differences and chi-squared analysis was used to determine differences in subtype. Results: In the 451 patients that met inclusion criteria, mean age was 41.1 (median = 44) and 48.2% were women. We found no differences in subtype by race or ethnicity. In addition, though the median age of AIS was similar by race, it was significantly lower in Hispanic patients compared to non-Hispanic patients (median Hispanic = 42; median non-Hispanic = 45; p = 0.024; table 1). Finally, the median ages of patients with cardioembolic (CE), cryptogenic and other subtypes were significantly lower than the median ages of patients with lacunar and large artery atherosclerosis (LAA) subtypes (median CE = 41yrs; median cryptogenic = 43 yrs; median other = 40 yrs; median lacunar = 47 yrs; median LAA = 47 yrs; figure 1). Conclusions: The proportion of AIS subtypes in a diverse urban cohort aged 19-49 did not vary by race or ethnicity. Patients with CE and cryptogenic stroke types were significantly younger than those with lacunar and LAA subtypes. More exploration of subtype-specific risk factors is needed to understand drivers of stroke in the young. Error bars indicate median and 95% CI. ** p <0.01; *** p <0.001; **** p <0.0001