Abstract TP217: Longitudinal Study of Young Patients With Embolic Stroke of Undetermined Source (ESUS)

Abstract

Introduction: Stroke in young adults is not rare, and can have a devastating, lasting impact. Up to 20% of patients with Embolic Stroke of Undetermined Source (ESUS) are under 50 years of age; thus, determining potential causes and outcomes in this younger cohort may significantly impact clinical practice. We aim to describe clinical, laboratory and imaging characteristics of patients between 21 and 50 years of age with ESUS; determine rates of new-onset atrial fibrillation; and investigate predictors of recurrent stroke in this unique population.

Methods: This is an ongoing multi-center, international registry, which plans to prospectively enroll 500 patients between the ages of 21-50 years with ESUS1 within 60 days. Clinical, laboratory and imaging data are documented at enrollment. Patients will be followed prospectively at 6, 12 and 18 months post-stroke via telephone interview to determine treatment and outcomes. End of enrollment is anticipated in mid-2019.

Results: Majority of patients are male (63.7%), and males had a higher median age at stroke than females (43 versus 41 years, range 21-50). Figure 1 shows the geographical breakdown of recruited patients. Intravenous recombinant tissue plasminogen activator (tPA) was given to 26/146 (17.8%). Median modified Rankin Score at time of stroke was 1.0 (range 0-5.0). Table 1 contains baseline characteristics and diagnostic workup of 146/187 patients enrolled thus far.

Conclusion: Demographics, stroke risk factors and recurrence rates may differ for younger patients with ESUS; thus, findings of this study could potentially shape clinical practice and ultimately improve outcomes for this at-risk population.