Risk Factor Profile in Different Subtypes of Acute Ischemic Stroke: A Prospective Observational Study

IntroductionAcute ischemic stroke is a major subtype of acute stroke. More than 65% of stroke-related deaths occur in developing countries. Various modifiable and non-modifiable risk factors are associated with the stroke. TOAST classification categorizes ischemic stroke into five etiologic subgroups. AimsTo identify subtypes of acute ischemic stroke and compare the influence of various risk factors on them. MethodologyA prospective observational study was conducted in a tertiary care teaching hospital. 200 consecutive patients diagnosed as having acute ischemic stroke were randomly enrolled. Patients were categorized into 3 groups-Group A: 18-39 years (17%); Group B: 40-60 years (20%) and Group C: >60 years (63%). Stroke subtypes were ascertained using TOAST classification. Data analysis was done. For categorical variables, data values were represented as numbers and percentages. A chi-square test was applied to find the level of significance. p value<0.05 was considered significant. ResultsThe study included 136 men and 64 women. Overall male dominance (Male: Female = 2.125:1), while in Group A, strong female dominance (Male: Female = 1:4.67) was observed. The commonest subtype was embolism (29.4%) in Group A, and small vessel disease in Group B, and C ((30% & 46.03% respectively). Hypertension was the commonest risk factor (62%). A higher incidence of hypertension was found in Group A (73.02%, p = 0.002), dyslipidemia in Group B (45%, p = 0.004), valvular heart disease (29.4%, p = 0.00001), and atrial fibrillation (29.4%, p = 0.005) in Group-C. Smoking and diabetes mellitus were strongly related to the male gender (p = 0.000001, p=0.002 respectively) and valvular heart disease to the female gender (p= 0.0002). ConclusionsAwareness of risk factors and lifestyle modifications may have a bearing on stroke prevention. Cardiovascular risk factors in young patients mandate the need for robust prevention and screening.