ABSTRACT NUMBER: ESOC2026A1816 RISK FACTORS FOR ISCHEMIC STROKE IN YOUNG ADULTS: AN OBSERVATIONAL STUDY

Abstract Background and aims Ischemic stroke in young adults is a heterogeneous condition with a high prevalence of potentially preventable risk factors and a significant proportion of embolic strokes of undetermined source (ESUS). Methods We performed a retrospective observational study including patients admitted with ischemic stroke between January 1, 2022 and January 1, 2025. Of 2614 ischemic stroke cases, 151 patients were aged <50 years. Demographic data, stroke severity (NIHSS at admission), acute treatment, vascular risk factors, and etiology were analyzed. Results Among the 151 (5,8%) young patients, 68.9% were male. Mean NIHSS score at admission was 7.6, and in-hospital mortality was 4.6%. Acute reperfusion therapy was administered in 29.9% of patients (intravenous thrombolysis 11.3%, mechanical thrombectomy 14.6%, combined therapy 4.0%). The most prevalent vascular risk factors were hypertension (80.8%), dyslipidemia (38.4%), smoking (37.1%), diabetes mellitus (18.5%), atrial fibrillation or prosthetic heart valves (12.6%), alcohol consumption (8.6%), active cancer (4.0%), arterial dissection (3.3%), illicit drug use (3.3%), oral contraceptive use (2.0%), radiation-induced vasculopathy (1.3%), left ventricular aneurysm (1.3%), and thrombophilia (0.7%). ESUS was identified in 16.6% of cases. Conclusions Although representing a small proportion of ischemic strokes, young adults had a high burden of modifiable risk factors and insufficient prevention, highlighting the need for earlier primary prevention. The substantial role of ESUS underscores the importance of thorough diagnostic workup and individualized secondary prevention in this population. Conflict of interest Felicia Glavan: Nothing to disclose