Abstract 17: Ischemic Stroke Profile, Risk Factors and Outcomes in India: The Indo-US Stroke Project

Background: There is limited data about ischemic stroke in India. We characterized the clinical profile, risk factors and predictors of outcome after stroke in the Indian population, and investigated regional variations. Methods: The Indo-US Stroke Registry and Infrastructure Development Project, jointly funded by NINDS and the Indian Department of Biotechnology, currently includes 5 geographically diverse centers in North and South India and one in Boston, USA. Trained MD co-investigators and research coordinators prospectively collect data on consecutive adult patients with imaging-confirmed ischemic stroke Results: From Nov-2012 to Jun-2013, 967 patients were enrolled. Mean age 59.7±13.9 yrs (range 20-92), 66% males. The patient population was 65% Hindu, 21% Sikh, 7% Christian, 6% Muslim, and 0.3% Jain; 58% had government health insurance. Only 3% arrived via EMS. Stroke risk factors included hypertension (66%), diabetes (39%), hyperlipidemia (20%), CAD (16%), atrial fibrillation (7.4%, rheumatic heart disease (5%). In addition to cigarette smoking (20%), exposure to beedi, hukkah, and smokeless tobacco (paan) was common (13%). The median admission NIHSS score was 9 (IQR, 5-15). Stroke subtypes using the automated ‘Causative Classification of Stroke’ program were large-artery atherosclerosis 31%, cardio-embolism 24%, small-vessel disease 15%, other defined causes 6%, and undetermined 24%. There were several regional differences, eg. hyperlipidemia, North 5% vs South 42% (p Conclusions: The data provide insights about stroke in a large developing country. Resources are needed to address risk factors, regional differences, and develop the infrastructure for stroke care in India.