London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 439 290 Etiology of stroke and risk factors Immune-inflammatory markers and arterial stiffness indexes in subjects with acute ischemic stroke with and without metabolic syndrome A. Tuttolomondo1, R. Pecoraro2, D. Di Raimondo3, V. Arnao4, A. Pinto5, G. Licata6 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo ( Italy), Palermo, ITALY1, Dipartimento Biomedico di Medicina Interna e Specialistica, Universi-tà degli Studi di Palermo ( Italy), Palermo, ITALY2, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo ( Italy), Palermo, ITALY3, Dipartimento di Biome-dicina Sperimentale e Neuroscienze Cliniche, Università degli Studi di Palermo, Palermo, ITALY4, ipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Università degli Studi di Paler-mo, Palermo, ITALY5, ipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Universi-tà degli Studi di Palermo, Palermo, ITALY6 Background: The aim of our study was to evaluate the associations between arterial stiffness and immune-inflam-matory markers in subjects with acute ischemic stroke with and without metabolic syndrome. Methods: 130 patients with acute ischemic stroke and metabolic syndrome, 127 patients with acute ischemic stroke without metabolic syndrome and 120 control subjects without acute stroke. Applanation to-nometry was used to record the augmentation index (Aix) and pulse wave velocity(PWV). We eval-uated plasma levels of some cytokines and adhesion molecules. Results: In subjects with acute ischemic stroke and metabolic syndrome compared to those without metabol-ic syndrome and contros we observed higher median plasma values of IL-1-beta IL-6 , mTNF-alfa E-selectin , P-selectin , VICAM-1 , ICAM-1 , vWF , PAI-1 and lower median plasma values of IL-10 pg/ml. we observed higher plasma values of CRP, IL-1beta, IL-6, TNF-alfa , E-Selectin, P-Selectin, ICAM- 1, VCAM-1, wWF, PAI-1 in subjects with LAAS, lacunar and CEI subtype ischemic stroke and metabolic syndrome compared to subjects with this subtype of stroke without metabolic syndrome. In subjects with acute ischemic stroke and metabolic syndrome compared to those without metabol-ic syndrome we observed a more significant positive correlation for age, and gender, between PWV and CRP TNF-alfa , IL1beta , IL-6, P-selectin and IL-6, vWF, PAI-1. In LAAS subjects and metabolic syndrome, PWV was more significantly and positively related to CRP, IL-1beta, IL-6, TNF-alfa, vWF and PAI-1 .In subjects with CEI subtype and metabolic syndrome, PWV was more significantly and positively related to PAI-1 and vWF but not with TNF-alfa, CRP, IL-6, IL-1beta . Conclusions Patients with metabolic syndrome and acute ischemic stroke have a higher degree of immune-in-flammatory markers strictly related to values of arterial stiffness indexes compared to stroke controls without metabolic syndrome and independently of stroke subtypes. 291 Etiology of stroke and risk factors Prevalence, Risk markers and Aetiology associated with Ischaemic Stroke in Young Patients at North Bristol NHS Trust, United Kingdom M. KAPOOR1, N. BALDWIN2 NORTH BRISTOL HOSPITALS NHS TRUST, BRISTOL, UNITED KINGDOM1, NORTH BRISTOL HOSPITALS NHS TRUST, BRISTOL, UNITED KINGDOM2 Background: Although many stroke patients are young or middle-aged, risk factor profiles and aeti-ology in these age groups are poorly understood. Method: A retrospective case-note review of patients aged 18 years to 55 years discharged with a primary diagnosis of ischaemic stroke from North Bristol NHS Trust, during the period from Octo-ber 2011 to September 2012. The data was collected on demographics, length of stay, risk factors, investigations undertaken and aetiology identified at discharge, using TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Results: A total of 67 patients were identified, representing 16.9% of all stroke discharges. We ana-lysed 63 case notes as insufficient data was available for the remaining four patients. Over one-half of the patients were of “undetermined cause” mainly due to incomplete investigation. Large artery atherosclerosis (25%) was the second most common cause of stroke, followed by cardioembolism, small vessel disease and ischaemic stroke of other determined aetiology (Table 1). The most com-mon risk factors were hyperlipidaemia (60.6%), hypertension (53.1%), current tobacco smoking (51.8%) and diabetes mellitus (7.5%). All patients with ischaemic stroke had vascular imaging, 63.3% underwent transthoracic echocardiogram with 15% having bubble contrast.100% had elec-trocardiogram (ECG) and only 13.9% underwent 24 hour ECG. More specific diagnostic tests were carried out in the minority. The in-hospital mortality rate was 2.9%. Conclusion: Young stroke patients have similar risk factor profiles as older patients, and require ag-gressive secondary prevention. However a significant proportion still have an undetermined cause hence a comprehensive cardiac assessment and/or specific diagnostic tests (angiography, cerebrospi-nal fluid examination, screening for vasculitis and thrombophilia, genetic testing and ophthalmologi-cal examination) is necessary to determine the aetiology. Table 1. Causes of Ischaemic Stroke in Young Adults Stroke of undetermined aetiology (mainly due to incomplete investi-gations) 32 Large-artery atherosclerosis (embolus/thrombosis) 16 Cardioembolism Patent Foramen Ovale 3 Atrial Fibrillation 2 Atrial Septal Defect 1 Left Ventricular Thrombus 1 Small-vessel occlusion (lacunae) 4 Stroke of other determined aetiology Thrombophilia 3 Ovarian Hyper Stimulation Syndrome 1
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