Etiology and risk factors of ischemic stroke in Indian-American patients from a hospital-based registry in New Jersey, USA

Background and Objective: The stroke center at the New Jersey Neuroscience Institute is located in Edison township in New Jersey which has one of the largest fractions of Asian immigrants in USA. This study aims to compare risk factors and etiology of ischemic stroke in patients of Indian origin with those of the White-Americans. Methods: Information pertaining to stroke risk factors was prospectively collected between July 2005 to June 2008. The patients underwent a stroke work-up, which included computerized tomograms, magnetic resonance imaging and magnetic resonance angiography of brain, carotid duplex, Holter monitoring and two dimensional echocardiogram. Etiology of ischemic stroke was ascertained using the classification developed for the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Results: The data of 378 patients (mean age = 71±12 years, 54% females, White-Americans=347) with ischemic stroke were collected over 3 years. The 31 Indian patients (mean age = 64±10 years) had a higher proportion of diabetics mellitus (p=0.001) and were signifi cantly younger than the White-Americans. There were signifi cantly lower proportion of persons who smoked (p=0.03) or used alcohol (p=0.03). The commonest cause of ischemic stroke was small vessel occlusive disease, rather than large artery atherosclerosis among the White-Americans (p=0.009). Conclusions: when compared to White-Americans, The Indian-American developed stroke at a younger age, despite a lower rate of alcohol and tobacco use. They have a higher prevalence of diabetes and physical inactivity. The commonest cause of ischemic stroke was small vessel occlusive disease