Abstract TP201: The Role Cardiovascular And Non-cardiovascular Risk Factors In The Development Of Strokes Among Young Adults

Background: We examined the effect of CV and non-CV risk factors on the development of strokes in young adults 18-55 years old. Methods: This case-control study, using the Colorado All Payer Claims Database (APCD), identified young adults with index stroke admissions and assigned them(1:3) to controls matched on age/sex/insurance type(commercial or public)/enrollment duration. Controls were assigned a proxy stroke date based on their matched case. CV and non-CV risk factors occurring from enrollment until 1 day prior to stroke date were included. Pregnancy, postpartum, and oral contraceptives were separated from other non-CV risk factors in women. To assess whether there was a differential effect of the risk factors by age in each sex, conditional logistic regression models were fit separately for men and women with an interaction between age and risk factor. Results: Between 2012-2018, 2735 index stroke admissions were identified (52.3% women) and matched to 8,178 controls. In men with stroke, 53.4% and 27.7% had at least one CV and non-CV risk factor, respectively. In women with stroke, 57.6%, 41.0%, and 12.1% had at least one CV, non-CV and hormonal risk factor, respectively. The most common CV risk factors were hypertension(27.8%), hyperlipidemia(26.8%), tobacco use(20.9%) in men and hypertension(25.5%), tobacco use(22.9%), obesity(22.6%) in women. The most common non-CV risk factors were migraines (14.3%), renal failure(6.9%), thrombophilia(6.1%) in men and migraines(29.1%), malignancy(9.5%), thrombophilia(6.7%) in women. Having one or more CV or non-CV risk factors significantly contributed to the development of strokes(Figure). Controlling for CV risk factors, having at least one non-CV risk factor had the highest risk among men and women <45. Hormonal risk factors significantly contribute to strokes in women ≥35. Conclusions: Non-CV risk factors play a significant role in the development of strokes among young adults and warrants further study.