Ethnic differences in stroke recurrence.
OBJECTIVE
To determine whether stroke recurrence and the effect of recurrence on mortality differ by ethnicity.


METHODS
Using methods from the Brain Attack Surveillance in Corpus Christi project, we prospectively identified first-ever ischemic strokes from emergency department logs and hospital admissions (January 2000 to December 2004). Recurrent strokes and deaths were identified for the same period. Cumulative probability of stroke recurrence was estimated. Cox proportional hazards models were used to examine ethnic differences in recurrence and to examine the relation among ethnicity, recurrence, and mortality.


RESULTS
During the time interval, 1,345 first-ever ischemic strokes were validated. Median age of patients was 72 years; 53% were Mexican American (MA). There were 126 recurrent strokes. Cumulative risk for recurrence at 30 days and 1 year was 2.6 and 7.5%, respectively. MAs had higher risk for stroke recurrence (risk ratio, 1.57; 95% confidence interval, 1.05-2.34) compared with non-Hispanic white patients, adjusted for demographics, stroke risk factors, and stroke severity. Stroke recurrence was related to mortality to a similar extent across ethnic groups (non-Hispanic white patients: risk ratio, 3.32; 95% confidence interval, 2.07-5.32; MAs: risk ratio, 2.35; 95% confidence interval, 1.42-3.88).


CONCLUSIONS
MAs had higher stroke recurrence risk compared with non-Hispanic white patients. Stroke recurrence had an important impact on mortality. Efforts to reduce stroke recurrence in MAs are needed.
Lisabeth
Lynda D
LD
Department of Epidemiology, University of Michigan School of Public Health, 109 South Observatory, Ann Arbor, MI 48109-2029, USA. llisabet@umich.edu
Smith
Melinda A
MA
Brown
Devin L
DL
Moyé
Lemuel A
LA
Risser
Jan M H
JM
Morgenstern
Lewis B
LB
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality; D016019:Survival Analysis; D013781:Texas / Q000453:epidemiology; D044465:White People