Abstract WP182: Etiological Profile of Ischemic Strokes in South Asians Differs Significantly from Other Populations

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Introduction: A growing body of evidence indicates that South Asians are at a higher risk of cardiovascular disease as compared to other racial/ethnic groups. However, limited data exist on how this increased risk translates to the observed incidence and distribution of ischemic stroke etiologies within this population. We aimed to characterize the etiological profile of acute ischemic stroke among South Asian patients to identify specific targets for more effective primary and secondary prevention. Methods: We conducted a key word search on PubMed, Scopus, the Cochrane Library, and Ovid. Peer-reviewed articles were included. Articles were excluded if there was no English translation available. A Chi-squared test (α = 0.05) was performed to determine if the observed etiological distribution of ischemic stroke in South Asians differed from pooled data reported across all racial/ethnic groups. Results: Out of 82 unique records identified, 14 articles met inclusion criteria, encompassing 7,621 South Asian patients with acute ischemic stroke. Common comorbidities included hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, central obesity, tobacco use, and alcohol use. Stroke etiology was unreported for 37.2% of patients; among the rest, large artery atherosclerosis accounted for 30.2% (1,446) of cases, small vessel occlusion for 26.5% (1,269), cardioembolic 16.3% (782), other determined etiologies for 1.5% (71), and embolic stroke of undetermined source for 8.1% (388) (Figure 1) . Chi-squared testing revealed a significant difference (p < 0.0001) between the observed and expected frequencies. Stroke location was missing for 94.5% of cases; where reported, 40.7% (170) were anterior circulation, 17.0% (71) were posterior circulation, and 39.7% (116) were lacunar infarcts of unspecified territory. Conclusions: Among South Asians, the observed etiological distribution of ischemic stroke differs significantly from the expected pattern reported across all racial/ethnic groups. This finding underscores the importance of developing primary and secondary prevention strategies that are specifically tailored to the distinct risk factor profiles for this population. However, current data are limited by a lack of population-specific studies and by significant variability in how stroke-related information is reported. Further research is needed to systematically collect data to inform and improve stroke care in South Asians.

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