title: Impact of risk factors for recurrent ischemic stroke in Prasat Neurological Institute.
abstract: BACKGROUND
  Recurrent strokes are more likely to be more disabling or fatal than first-even strokes. The high frequency of recurrences underscores the importance ofsecondary prevention.
  
  
  OBJECTIVE
  Investigate risk factors of recurrent ischemic stroke and to compare the outcomes after treatment following the Thai stroke guideline between patients with recurrent ischemic stroke and patients without recurrent ischemic stroke.
  
  
  METHODS
  Sixty-seven patients with recurrent ischemic stroke and 167 patients without recurrent ischemic stroke were included in the present study. All patients were evaluated for demographic data, modifiable risk factors, and treatment.
  
  
  RESULTS
  Patients without recurrent ischemic stroke had better controlled level of systolic blood pressure, diastolic blood pressure, and higher high-density lipoprotein level than patients with recurrent ischemic stroke. Carotid stenosis was higher in patients with recurrent ischemic stroke (43.3% vs. 28.7%, p = 0.032). Patients with recurrent ischemic stroke received statin therapy (67.2% vs. 86.8%, p = 0.001) and folic acid (61.2% vs. 78.4%, p = 0.007) less than patients without recurrent ischemic stroke. The multivariate analysis showed that well controlled diastolic blood pressure (p = 0.014), higher level of high-density lipoprotein (p = 0. 010), and receiving of statin (p = 0.002) were associated with decreased incidence of recurrent ischemic stroke.
  
  
  CONCLUSIONS
  Well-controlled risk factors including blood pressure, fasting blood sugar, high-density lipoprotein, and low-density lipoprotein were crucial for the protection of recurrent ischemic stroke. Furthermore, the benefits of statin and folic acid therapies for the protection of recurrent ischemic stroke were emphasized
authors.affiliation: Prasat Neurological Institute, Bangkok, Thailand. narupatr@hotmail.com
authors.forename: Narupat
authors.initials: N
authors.lastname: Suanprasert
authors.forename: Tassanee
authors.initials: T
authors.lastname: Tantirithisak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy* / Q000453:epidemiology; D016893:Carotid Stenosis / Q000150:complications / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008075:Lipoproteins, HDL / Q000378:metabolism; D008077:Lipoproteins, LDL / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D005492:Folic Acid