Clinical profile, risk factors and aetiology of young ischaemic stroke patients in Asia: A prospective, multicentre, observational, hospital-based study in eight cities

Kay Sin Tan; Navarro, Jose C.; Ka Sing Wong; Yi Ning Huang; Hou Chang Chiu; Niphon Poungvarin; Shan Jin Ryu; Bitanga, Ester; Nijasri Suwanwela; Alam, Sardar Mohd; Byung Woo Yoon
June 2014
Neurology Asia;Jun2014, Vol. 19 Issue 2, p117
Academic Journal
Background and Objective: There is a lack of international collaborative studies on young adults with ischaemic stroke in Asia. The aim of this study was to investigate risk factors, aetiology and outcome at hospital discharge of these patients across 8 participating countries in Asia. Methods: This was a prospective, observational, multicentre, hospital based cohort study. Consecutive young stroke patients with confirmed cerebral infarction between the ages of 18-49 were recruited from December 2011 to May 2012. Data was collected for patient demography, risk factors, investigations, clinical profile and TOAST classification. Outcome measures were death and independence (modified Rankin score⩽ 2) at hospital discharge. Results: Two hundred and eighteen patients with the mean age was 40.8±6.7 years were recruited. There was a larger proportion of male patients with a ratio of 1.9:1. Traditional risk factors observed were hypertension (n=103; 47.3%), dyslipidaemia (n=93; 42.4%), smoking (n=85; 38.8%), diabetes (n=53; 24.3%), alcohol use (n=33; 15.0%), a previous history of stroke and transient ischaemic attacks (6.4%), family history (n=12; 5.5%), migraine (n=6;2.8%), pregnancy related (n=5; 2.3%) and numerous cardiac risk factors (0.9-5.5%). The majority suffered arterial infarction; n=216 (99.4%) while n=2 (0.6%) had venous strokes. The predominant stroke subtypes were large artery atherosclerosis (LAA); 29.8% and small vessel occlusion (SVO); 20.2%. LAA and SVO accounted for 37.5% of all stroke subtypes in the ⩽36 year age-group. Cardioembolism (15.1%) and stroke of determined aetiology (14.7%) contributed to the other categories of identified stroke subtypes. Mortality on hospital discharge was 3.1% while 65.1% of patients were independent on discharge. Conclusion: This study demonstrated the substantial presence of premature atherosclerosis and conventional risk factors in young ischaemic stroke patients from 8 Asian cities. Venous infarction from cerebral venous thrombosis was rare in this study. Outcome on hospital discharge was poorer compared to Western studies. Detection of vascular risk factors and primary prevention measures should be initiated during late adolescence or early adulthood in urban Asia.


Related Articles

  • Hyperthermia in Human Ischemic and Hemorrhagic Stroke: Similar Outcome, Different Mechanisms. Campos, Francisco; Sobrino, Tomás; Vieites-Prado, Alba; Pérez-Mato, María; Rodríguez-Yáñez, Manuel; Blanco, Miguel; Castillo, José // PLoS ONE;Nov2013, Vol. 8 Issue 11, p1 

    Hyperthermia is a predictor of poor outcome in ischemic (IS) and intracerebral hemorrhagic (ICH) stroke. Our aim was to study the plausible mechanisms involved in the poor outcome associated to hyperthermia in stroke. We conducted a case-control study including patients with IS...

  • Electroencephalography Patterns and Prognosis in Acute Ischemic Stroke. Lima, Fabricio O.; Ricardo, João a.G.; Coan, ana C.; Soriano, Diogo C.; avelar, Wagner M.; Min, Li L. // Cerebrovascular Diseases;Oct2017, Vol. 44 Issue 3/4, p128 

    Background and Purpose: The prognostic significance of interictal epileptiform discharges (IED) and periodic patterns (PP) after ischemic stroke has not been assessed. We sought to test whether IED and PP, detected on standard Electroencephalography (EEG) performed during the acute phase of...

  • The Impact of Pregnancy on Hemorrhagic Stroke in Young Women. Miller, Eliza C.; Sundheim, Kathryn M.; Willey, Joshua Z.; Boehme, Amelia K.; Agalliu, Dritan; Marshall, Randolph S. // Cerebrovascular Diseases;Sep2018, Vol. 46 Issue 1/2, p10 

    Background: Pregnancy is a sex-specific risk factor for causing hemorrhagic stroke (HS) in young adults. Unique physiological characteristics during pregnancy may alter the relative risk for HS in pregnant/postpartum (PP) women compared to HS in other young women. We compared patient...

  • Frequency of Maternal and Newborn Birth Outcomes, Lima, Peru, 2013. Wynn, Adriane; Cabeza, Jeanne; Adachi, Kristina; Needleman, Jack; Garcia, Patricia J.; Klausner, Jeffrey D. // PLoS ONE;Mar2015, Vol. 10 Issue 3, p1 

    Objective: This study describes the pregnancy and birth outcomes at two hospitals in Lima, Peru. The data collection and analysis is intended to inform patients, providers, and policy makers on Peru’s progress toward achieving the Millennium Development Goals and to help set priorities...

  • Clinical and trans-esophageal echocardiographic evaluation of patent foramen ovale in young Iraqi patients with ischemic stroke. Amin, Osama Shukir Muhammed; Al-Jumaily, Hasan // Tikrit Medical Journal;2012, Vol. 18 Issue 1, p1 

    Patent foramen ovale (PFO) has been long identified as a potential risk factor for stroke, but the mechanism or mechanisms of PFO-associated stroke remain unsettled and controversial till now. Aim: To evaluate possible differences in stroke risk factors and stroke patterns between patients with...

  • When cardiac chest pain is not confirmed by tests. Stokell, Richard // Pulse;9/8/2003, Vol. 63 Issue 36, p78 

    Focuses on the clinical case of patient treated for hypertension and obesity. Requirements for patient's admission; Discussion of the patient's angiogram result; Discharge of the patient from the clinic.

  • Incomplete Large Vessel Occlusions in Mechanical Thrombectomy: An Independent Predictor of Favorable Outcome in Ischemic Stroke. Maus, Volker; You, Seunghwa; Kalkan, alev; Borggrefe, Jan; Kabbasch, Christoph; Barnikol, Utako Birgit; Stetefeld, Henning; Dohmen, Christian; Liebig, Thomas; Fink, Gereon Rudolf; Mpotsaris, anastasios // Cerebrovascular Diseases;Oct2017, Vol. 44 Issue 3/4, p113 

    Background and Purpose: Cerebral large vessel occlusion (LVO) in acute ischemic stroke (AIS) may be complete (CLVO) or incomplete (ILVO). The influence of ILVO on clinical outcome after mechanical thrombectomy (MT) remains unclear. We investigated primarily the clinical outcome in patients with...

  • Prehypertension linked to risk of stroke.  // Research Review (International Council on Active Aging);10/12/2011, Vol. 11 Issue 37, p1 

    The article presents the results of a study on the relationship between prehypertension and risk of stroke, published in the October 4, 2011 issue of the journal "Neurology."

  • Men and Stroke and What You Need to Know.  // Tennessee Tribune;11/5/2015, Vol. 26 Issue 45, p11B 

    The article offers information on strokes including details of ischemic and hemorrhagic strokes, referring loss of balance as symptom of stroke, and mentioning high blood pressure as risk factor for stroke.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics