Analysis of the Causes and Risk Factors of Ischemic Stroke in Youth by TOAST Criteria

Objective To explore the causes and risk factors of ischemic stroke in young adults.Methods According to the Trial of Org10172 in Acute Stroke Treatment(TOAST) criteria,72 young patients(≤45 years old) were included in this study.Data about causes and risk factors of ischemic stroke were collected and analyzed prospectively from consecutive stroke inpatients in the First Affiliated Hospital of Medical College of Shantou University from Jan.2009 to Dec.2011.Results The proportion of ischemic stroke subtypes according to TOAST criteria was as follows: stroke of cardioembolism(CE) 19.4%,large-artery atherosclerosis(LAA) 13.9%,small-vessel occlusion(SAO) 26.4%,stroke of other determined etiology(OD) 12.5%,stroke of undetermined etiology(UND) 27.8%.The highest exposure ratios of risk factors were hypertension(41.7%),blood lipid abnormality(34.7%),diabetes(18.1%),smoking(15.3%),alcohol consumption(9.7%).Univariate analysis of the risk factors between the stroke subgroups showed that hypertension(70%,χ2=11.82,P0.05) increased significantly in SAO subtype.Blood lipid abnormality(77.8%,χ2=9.50,P0.05) increased significantly in OD subtype.Conclusion The UND and CE and LAA subtypes were the most common etiological types in young adults,especially in more than 35 years old.The exposure ratios of risk factors were the highest in hypertension and lipid abnormality.The study may provide an instruction for prevention and treatment different subtype in ischemic stroke for young adults.