Chinese Ischemic Stroke Subclassification and Risk Factors in Ischemic Stroke in Young Adults

Objective To explore the characteristics of Chinese ischemic stroke subclassification(CISS) classification and risk factors in ischemic stroke in young adults and to provide the basis for prevention and treatment.Methods There were 52 young adults with ischemic stroke who were hospitalized in our department in 2011. These patients were enrolled in young patient group while 50 middle-aged and old patients with ischemic stroke enrolled in middle-aged and old patient group. Their CISS classification and risk factors were analyzed retrospectively.Results ①88.46% patients in young patient group are male, the percentage is significantly higher than in middle-aged and old patient group(χ2=5.573, P =0.018). ②The CISS classification in young patient group was as follows: large artery atherosclerosis(LAA) 46.15%, penetrating artery disease(PAD) 36.54%, undetermined etiology(UE) 11.54%, cardiogenic stroke(CS) 5.77%, and no other etiology(OE). Compared with middle-aged and old patient group, there is no significant difference. ③The common risk factors for young patient group are listed in order as follows: smoking, hypertension, hyperlipidaemia, alcoholism, diabetes mellitus and family history. More than half of the patients in young patient group had more than three risk factors, and this numberis significantly larger than that of middle-aged and old patient group(χ2=7.186, P =0.007). The concentration of homocysteine(Hcy)(t =1.250, P =0.038) and the occurrence rate of smoking(χ2=7.993, P=0.005) and alcoholism(χ2=17.005, P=0.000) in young patient group are significantly higher than those in middle-aged and old patient group; the concentration of folic acid is significantly lower(t =2.106, P =0.007); and the concentration of Hcy in LAA is significantly higher than that in PAD in young patient group(t =2.046, P=0.004).Conclusion We should pay more attention to the concentration of Hcy in patients with ischemic stroke as it may be related to the age of onset and the CISS classification. The young adults with ischemic stroke have more risk factors than middle-aged and old patients. Improving and reducing the risk factors, especially improving hyperhomocysteinemia, are important to prevent against ischemic stroke in young adults.