Stroke recurrence among 30 days survivors of ischemic stroke in a prospective community-based study.
A cohort of 209 patients (105 men and 104 women), who survived 30 days after 'first ever-in-lifetime ischemic stroke' were followed for one year. Predictors of survival were examined by log-rank test and Cox proportional hazards method. Twenty-four patients had a stroke recurrence (11.4%). Thirteen of the patients with recurrent stroke (54%) died because of the sequelae of the second stroke. Stroke recurred in 16% of patients with stroke due to atherosclerosis, in 12.5% of patients with cardioembolic stroke, and in 4.4% of patients with lacunar stroke. The life table cumulative risk of death at 6 and 12 months for patients with recurrent stroke was statistically higher (22% and 57%) than patients without recurrent stroke (13% and 29% respectively). History of untreated hypertension prior to the initial stroke (RR = 1.7, 95% Cl 1.2-4.1, p < 0.05) was an independent predictor of recurrence. In 134 patients (64.9%) aspirin was initiated during the first month after stroke. Only 81 patients (39.8%) continued aspirin treatment for the whole year. Life table cumulative risk of mortality among the patients treated with aspirin was 8% at 6 months and 12% at 1 year compared to 19% at 6 months and 45% at 12 months for those untreated with aspirin. We conclude that the high risk of recurrent stroke in Poland could be redaced by increased use of anti-platelets therapy and anti-hypertensive therapy after ischemic stroke.
Ryglewicz
D
D
2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
Baranska-Gieruszczak
M
M
Czlonkowska
A
A
Lechowicz
W
W
Hier
D B
DB
D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000401:mortality; D001241:Aspirin / Q000494:pharmacology; D002545:Brain Ischemia / Q000150:complications / Q000401:mortality*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D011044:Poland; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D016019:Survival Analysis
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin