Early recurrence of ischemic stroke in Japanese patients: the Japan standard stroke registry study.
BACKGROUND
To determine the factors that contribute to early ischemic stroke recurrence in Japanese patients.


METHODS
A multicenter stroke registration study based on a computerized database from 54 Japanese institutes, involving 8,036 patients with brain infarction who were hospitalized within 48 h after symptom onset between January 2000 and March 2004.


RESULTS
Within 30 days after the initial stroke, 395 patients (4.9%) developed a recurrent stroke. Recurrence most frequently occurred in atherothrombotic patients (6.6%), followed by cardioembolic patients (6.2%). Overall, hypertension (OR 1.348, 95% CI 1.071-1.696) and atrial fibrillation (OR 1.503, 95% CI 1.177-1.918), but not diabetes mellitus, were independently predictive of early recurrence. In atherothrombotic patients, diabetes mellitus (OR 1.485, 95% CI 1.058-2.085) and atrial fibrillation (OR 1.998, 95% CI 1.231-3.244) were independently related to early recurrence. At hospital discharge, the modified Rankin Scale score was higher in patients who had an early recurrence (p < 0.0001).


CONCLUSIONS
This study was based on a large number of Japanese patients and confirmed that hypertension and atrial fibrillation contribute to early ischemic stroke recurrence. In addition, analysis by stroke subtype showed that diabetes mellitus was independently related to early recurrence in atherothrombotic patients.
Toyoda
Kazunori
K
Department of Medicine, Cerebrovascular Division, National Cardiovascular Center, Suita, Japan. toyoda@hsp.ncvc.go.jp
Okada
Yasushi
Y
Kobayashi
Shotai
S
D044466:Asian People / Q000706:statistics & numerical data*; D001281:Atrial Fibrillation / Q000150:complications; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology*; D048909:Diabetes Complications / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007564:Japan / Q000453:epidemiology; D016017:Odds Ratio; D012008:Recurrence; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors