Raja Farhat Shoaib
Shifa International Hospital, Islamabad
Posters & Accepted Abstracts: J Neurol Neurophysiol
Background and Purpose: The purpose of this study was to determine the frequency of ischemic stroke subtypes based on TOAST classification in a tertiary care center in Islamabad and quantify them according to age, Gender and risk factors. Methods: We identified 145 patients who presented to Shifa international Hospital, Islamabad from Nov 2015 to Feb 2016 with neurological deficits consistent with ischemic stroke and were confirmed by CT and MRI. The cause of ischemic stroke was classified according to TOAST criteria. Results: A cross sectional study was conducted in Stroke unit of SIH. 145 patients diagnosed with Ischemic stroke were included. Mean age was 65+- 14 years. Majority were males (54.1%).Hypertension (62.3%) was the most common risk factor followed by dyslipidemia (44.6%), Diabetes (32.2%), smoking (16.8%) and atrial fibrillation (10.4%). Cardio-embolic (40%) was the most common subtype followed by stroke of undetermined etiology (26.89%),small vessel disease( 17.24% ), large vessel disease ( 13.79% ) and stroke of other etiology was found in 2.06%. In Cardioembolic stroke, atrial fibrillation was found in 41 %,left atrial turbulence in 27%,hypokinetic left ventricular segment in 20 %,chronic heart failure in 18.6 %,left atrial thrombus 6.9%, mitral stenosis plus atrial fibrillation 4.6%, rheumatic heart disease 4.6 %, DCMP, infective endocarditis, mitral stenosis without atrial fibrillation, mitral annular calcification, recent MI each accounted for 2.3 % Conclusion: Our study concludes that cardio-embolic stroke is the most common cause of acute ischemic strokes in our stroke unit, and our results are also supported by Western literature. Hypertension Diabetes Mellitus and dyslipidemia were the most common risk factors. Atrial fibrillation is the most common cause of Cardioembolic stroke.