ABSTRACT NUMBER: ESOC2026A2036 THE EFFECT OF SOSIOECONOMIC STATUS ON THE RISK OF CRYPTOGENIC ISCHEMIC STROKE IN YOUNG ADULTS

Abstract Background and aims Underlying risk factors for young-onset cryptogenic ischemic stroke (CIS) remain unclear. We aimed to explore the association between socioeconomic status and CIS, including sex-specific subgroup analyses. Methods We prospectively enrolled 540 patients aged 18-49 years (median age 41 years; 47% women) with a recent CIS and 540 age- and sex-matched (±5 years) stroke-free controls in an international multicenter study. Perceived social support was assessed using the Oslo Social Support Scale and categorized as poor, moderate, or strong. Educational level, vocational status, household status (i.e. living alone), and marital status were also recorded. Conditional logistic regression adjusted for age and relevant risk factors was used to evaluate independent associations between socioeconomic factors and CIS. Results Compared with controls, patients more often had hypertension, smoked, used more alcohol, were overweight, and physically inactive. They also reported poorer social support, had lower education, and were more frequently unemployed before stroke. There were no differences in marital or household status. In the full cohort, poor social support (adjusted odds ratio [aOR] 3.66; 95% confidence interval [CI] 1.35-9.90), lower education (aOR 1.65; 1.23-2.11), and unemployment (aOR 1.92; 1.12-3.31) were independently associated with CIS. No associations were found for marital or household status. In sex-stratified analyses, these associations remained significant in women (poor social support aOR 4.62; 1.26–16.98; lower education aOR 1.78; 1.16–2.79; unemployment aOR 2.60; 1.24–5.45), but not in men. Conclusions Poor social support, lower education, and unemployment appear to be contributors to young-onset CIS, particularly in women. Conflict of interest All authors: nothing to disclose