Atherosclerotic Risk Factor Prevalence in Young Adults with Stroke and Acute Myocardial Infarction (P6.248)

Objective: To better understand the role of atherosclerotic risk factors (ARF) in stroke versus acute myocardial infarction (AMI) in young adults. Background: ARF are known causes of stroke and AMI in older adults. However, their role in young adult stroke is largely unknown. Design/Methods: Using a 10% random sample of a commercial claims database, we analyzed all enrollees aged 15–45 between 2001–2014. ARF including hypertension, hyperlipidemia and diabetes were determined by 2 outpatient or 1 inpatient claim by ICD-9. Individual claims for first ever stroke or AMI hospitalizations were identified. For stroke or AMI patients, ARF were required to be diagnosed before the stroke or AMI admission. GEE Poisson regression model was used to calculate the incidence rate ratio of stroke or AMI, controlling for age and gender. Results: Of 3.7 million young adults, 3357 had first-time stroke, and 3020 had first time AMI. The mean age overall was 28, while the mean age of first-time stroke and AMI were 37 and 39, respectively. 52% of participants overall were female, while 55% of stroke and 40% of AMI cohorts were female. Overall prevalence of ARF were low: 6.8% for hypertension, 2.3% for diabetes, and 6.8% for hyperlipidemia. The prevalence of all ARF were significantly higher in AMI than stroke (stroke: 53.7% hypertension, 20.9% diabetes, 41.1% hyperlipidemia; AMI: 67.4% hypertension, 23.1% diabetes, 70% hyperlipidemia). Patients with hypertension were 4.9 and 5.9 times more likely to have AMI and stroke, respectively. Similarly, stroke and AMI risk ratios were increased with diabetes (5.0 and 5.8 respectively) and hyperlipidemia (3.1 and 2.8 respectively). Conclusions: ARF are more strongly associated with AMI than stroke. The AMI cohort is older, more male and has a higher prevalence of ARFs. ARF pose a significant risk of strokes and AMI in young adults and aggressive prevention and risk factor management is advised. Study Supported by: American Heart Association, Bugher Foundation Disclosure: Dr. Leppert has nothing to disclose. Dr. Burke has nothing to disclose. Dr. Campbell has nothing to disclose. Dr. Bernard has nothing to disclose. Dr. Sillau has nothing to disclose. Dr. Ho has nothing to disclose. Dr. Leppert has nothing to disclose.