ABSTRACT NUMBER: ESOC2026A451 ESTONIAN YOUNG STROKE REGISTRY: DO YOUNG PATIENTS ADHERE TO SECONDARY PREVENTION AFTER ISCHEMIC STROKE?

Abstract Background and aims Effective secondary prevention is essential for preventing stroke recurrence. We evaluated adherence to prescribed secondary stroke-prevention medications among young ischemic stroke patients, examined how overall risk-factor burden relates to follow-up attendance and adherence, and assessed factors associated with medication use. Methods We used prospective Estonian Young Stroke Registry data on patients aged 18–54 years hospitalized with acute ischemic stroke (AIS) in 2013-2023. Adherence was defined as continuation of the same secondary prevention medication regimen at the 3-month follow-up visit as prescribed at discharge. Assessed risk factors included lifestyle, metabolic and cardiovascular factors. Stroke risk-factor burden was defined as the baseline count of predefined risk factors. Statistical analyses were performed using SPSS. Results Among 544 patients with AIS (63.1% male, mean age 44.8±8.3 years), 3-month follow-up data were available for 372 patients (68.4%), of whom 281 (75.5%) adhered to the prescribed regimen. Patients lost to follow-up were older, more frequently male and smokers, and had higher ischemic heart disease rates and more severe strokes. Adherence to secondary stroke-prevention medications was highest for antidiabetic drugs (100%) and lowest for diuretics (85.2%). Follow-up attendance was similar across risk-factor categories, whereas treatment adherence was higher among patients with lower risk-factor burden. Age was the only independent significant predictor of adherence (p=0.003, OR=0.952, 95% CI 0.922–0.983), with each additional year of age reducing adherence odds by approximately 5%. Conclusions Early discontinuation of secondary stroke-prevention medication underscores the need for thorough patient counseling at discharge and timely follow-up to prevent recurrence and improve long-term outcomes. Conflict of interest All the authors have nothing to disclose.