Risk Factors of Transient Ischemic Attack in Young Adults in Pakistan
Risk Factors of Transient Ischemic Attack
DOI:
https://doi.org/10.54393/pjhs.v4i11.1177Keywords:
Risk Factors, Stroke, Transient Ischemic AttackAbstract
Transient ischemic attacks precede about 20%-25% of ischemic stroke. These symptoms normally range from a few seconds to several minutes, with a typical duration of less than one hour. Objective: To assess the risk factors of transient ischemic attack in young adults. Methods: This prospective study was conducted at the People's University of Medical and Health Sciences Hospital, Nawabshah. Patients with stroke admitted to Medical Units I, II, and III from November 2021 to June 2023 were eligible for inclusion. This study eliminated those who were under the age of 18, those who had experienced brain injury, and those who were above the age of 45. The current study included 209 patients, including both male and female participants aged between 18 and 45 years, who exhibited various forms of stroke. For this study, only 14 (6.7%) patients with transient ischemic attack (TIA) were selected. Data on diagnostic tests, medical records, laboratory investigations, and radiological images were obtained for data collection. Results: The most prevalent risk factor was diabetes mellitus in nine (64.3%) patients. Seven (50.0%) patients had hypertension. Cardiac disease was seen in six (42.9%) of patients. Smoking and previous stroke history were observed in one (7.1%) patient each. Conclusions: The results of this research suggested that diabetes mellitus, hypertension, and heart problems are the predominant risk factors associated with transient ischemic stroke in young individuals.
References
Rothwell PM and Warlow CP. Timing of TIAs preceding stroke: time window for prevention is very short. Neurology. 2005 Mar; 64(5): 817–20. doi: 10.1212/01.WNL.0000152985.32732.EE. DOI: https://doi.org/10.1212/01.WNL.0000152985.32732.EE
Fisher CM. Transient Ischemic Attacks. New England Journal of Medicine. 2002 Nov; 347(21): 1642–3. doi: 10.1056/NEJMp020129. DOI: https://doi.org/10.1056/NEJMp020129
Albers GW, Caplan LR, Easton JD, Fayad PB, Mohr JP, Saver JL, et al. Transient Ischemic Attack — Proposal for a New Definition. New England Journal of Medicine. 2002 Nov; 347(21): 1713–6. doi: 10.1056/NEJMsb020987. DOI: https://doi.org/10.1056/NEJMsb020987
Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease: the American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009 Jun; 40(6): 2276–93. doi: 10.1161/STROKEAHA.108.192218. DOI: https://doi.org/10.1161/STROKEAHA.108.192218
Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014 Jul; 45(7): 2160–236. doi: 10.1161/STR.0000000000000024. DOI: https://doi.org/10.1161/STR.0000000000000024
Linden B. National Institute for Health and Care Excellence NG128 stroke and transient ischaemic attack in over 16s: diagnosis and initial management. British Journal of Cardiac Nursing. 2020 Sep; 15(9): 1-5. doi: 10.12968/bjca.2020.0121 DOI: https://doi.org/10.12968/bjca.2020.0121
George MG, Tong X, Bowman BA. Prevalence of cardiovascular risk factors and strokes in younger adults. JAMA Neurology. 2017 Jun; 74(6): 695–703. doi: 10.1001/jamaneurol.2017.0020. DOI: https://doi.org/10.1001/jamaneurol.2017.0020
Kissela BM, Khoury JC, Alwell K, Moomaw CJ, Woo D, Adeoye O, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology. 2012 Oct; 79(17): 1781–7. doi: 10.1212/WNL.0b013e318270401d. DOI: https://doi.org/10.1212/WNL.0b013e318270401d
Kivioja R, Pietilä A, Martinez-Majander N, Gordin D, Havulinna AS, Salomaa V, et al. Risk factors for Early-Onset ischemic stroke: a Case-Control study. Journal of the American Heart Association. 2018 Nov; 7(21): e009774. doi: 10.1161/JAHA.118.009774. DOI: https://doi.org/10.1161/JAHA.118.009774
Singhal AB, Biller J, Elkind MS, Fullerton HJ, Jauch EC, Kittner SJ, et al. Recognition and management of stroke in young adults and adolescents. Neurology. 2013 Sep; 81(12): 1089–97. doi: 10.1212/WNL.0b013e3182a4a451. DOI: https://doi.org/10.1212/WNL.0b013e3182a4a451
Béjot Y, Bailly H, Durier J, Giroud M. Epidemiology of stroke in Europe and trends for the 21st century. Presse Médicale. 2016 Dec; 45(12): e391–8. doi: 10.1016/j.lpm.2016.10.003. DOI: https://doi.org/10.1016/j.lpm.2016.10.003
Ji R, Schwamm LH, Pervez MA, Singhal AB. Ischemic stroke and transient ischemic attack in young adults: risk factors, diagnostic yield, neuroimaging, and thrombolysis. JAMA Neurology. 2013 Jan; 70(1): 51–7. doi: 10.1001/jamaneurol.2013.575. DOI: https://doi.org/10.1001/jamaneurol.2013.575
Syed NA, Khealani BA, Ali S, Hasan A, Brohi H, Mozaffar T, et al. Ischemic stroke subtypes in Pakistan: the Aga Khan University stroke data bank. Journal of Pakistan Medical Association. 2003 Dec; 53(12): 584.
Vohra EA, Ahmed WU, Ali M. Aetiology and prognostic factors of patients admitted for stroke. The Journal of the Pakistan Medical Association. 2000 Jul;50(7):234–6.
Smajlović D. Strokes in young adults: epidemiology and prevention. Vascular Health and Risk Management. 2015 Feb; 157–64. doi: 10.2147/VHRM.S53203. DOI: https://doi.org/10.2147/VHRM.S53203
Putaala J, Metso AJ, Metso TM, Konkola N, Kraemer Y, Haapaniemi E et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. stroke. 2009 Apr; 40(4): 1195-203. doi: 10.1161/STROKEAHA.108.529883 DOI: https://doi.org/10.1161/STROKEAHA.108.529883
Van Tassell BW, Toldo S, Mezzaroma E, Abbate A. Targeting interleukin-1 in heart disease. Circulation. 2013 Oct; 128(17): 1910–23. doi: 10.1161/CIRCULATIONAHA.113.003199. DOI: https://doi.org/10.1161/CIRCULATIONAHA.113.003199
Chand P, Ibrahim S, Matloob Alam M, Arain F, Khealani B. Acute childhood ischemic stroke: a Pakistani tertiary care hospital experience. Pakistan Journal of Neurological Sciences (PJNS). 2016; 11(1): 3–6.
Tibæk M, Dehlendorff C, Jørgensen HS, Forchhammer HB, Johnsen SP, Kammersgaard LP. Increasing incidence of hospitalization for stroke and transient ischemic attack in young adults: a registry-based study. Journal of the American Heart Association. 2016 May; 5(5): e003158. doi: 10.1161/JAHA.115.003158. DOI: https://doi.org/10.1161/JAHA.115.003158
Giovannoni G and Fritz VU. Transient ischemic attacks in younger and older patients. A comparative study of 798 patients in South Africa. Stroke. 1993 Jul; 24(7): 947–53. doi: 10.1161/01.STR.24.7.947. DOI: https://doi.org/10.1161/01.STR.24.7.947
Janssen AWM, De Leeuw FE, Janssen MCH. Risk factors for ischemic stroke and transient ischemic attack in patients under age 50. Journal of Thrombosis and Thrombolysis. 2011 Jan; 31: 85–91. doi: 10.1007/s11239-010-0491-3. DOI: https://doi.org/10.1007/s11239-010-0491-3
Tan YF, Zhan LX, Chen XH, Guo JJ, Qin C, Xu E. Risk Factors, Clinical Features and Prognosis for Subtypes of Ischemic Stroke in a Chinese Population. Current Medical Science. 2018 Apr; 38(2): 296–303. doi: 10.1007/s11596-018-1878-1. DOI: https://doi.org/10.1007/s11596-018-1878-1
Collaborators NMSS, Sacco RL, Boden-Albala B, Gan R, Chen X, Kargman DE, et al. Stroke incidence among white, black, and Hispanic residents of an urban community: the Northern Manhattan Stroke Study. American Journal of Epidemiology. 1998 Feb; 147(3): 259–68. doi: 10.1093/oxfordjournals.aje.a009445. DOI: https://doi.org/10.1093/oxfordjournals.aje.a009445
Ferro JM and Crespo M. Prognosis after transient ischemic attack and ischemic stroke in young adults. Stroke. 1994 Aug; 25(8): 1611–6. doi: 10.1161/01.STR.25.8.1611 DOI: https://doi.org/10.1161/01.STR.25.8.1611
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments