title: Features of acute ischemic stroke with rheumatic heart disease in a hospitalized Chinese population.
abstract: OBJECTIVE
  Rheumatic heart disease (RHD) is an important risk factor for ischemic stroke in developing countries. Observational data on its characteristics and influence on outcome or recurrence of ischemic stroke are scarce. We aimed to investigate proportions, characteristics, functional outcome, and recurrence of acute ischemic stroke patients with RHD in a hospitalized Chinese population.
  
  
  METHODS
  We prospectively enrolled consecutive patients with acute ischemic stroke who were admitted within 1 month of stroke onset from January 2003 to February 2007, into the analysis. Clinical characteristics such as age, gender, risk factors, and National Institutes of Health Stroke Scale on admission were investigated. Basic characteristics, functional outcomes, and recurrence were compared between RHD group and nonRHD group.
  
  
  RESULTS
  Of the 1638 cases included, RHD was present in 130 patients (7.9%). RHD patients, compared with those without RHD, were younger, more frequently female, and more often had experienced atrial fibrillation and higher National Institutes of Health Stroke Scale score on admission (all P<0.006). After adjustment for age, sex, and National Institutes of Health Stroke Scale on admission, the death risk in patients with RHD was 2.0-fold higher at 3 months, 6 months, and 1 year compared with patients without RHD (all P<0.013). Compared with patients without RHD, those with RHD showed a significantly higher cumulative recurrence rate (13.6% vs 6.0%; P=0.001, log rank test) by 1-year cumulative recurrent curves.
  
  
  CONCLUSIONS
  Stroke attributable to RHD is still common in the Chinese population. RHD was associated with 2-fold increased risk of death and 1-fold increased risk of recurrence in stroke patients.
authors.affiliation: Stroke Clinical Research Unit, Department of Neurology, West China Hospital, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan Province, PR China.
authors.forename: Deren
authors.initials: D
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Zilong
authors.initials: Z
authors.lastname: Hao
authors.forename: Wendan
authors.initials: W
authors.lastname: Tao
authors.forename: Sen
authors.initials: S
authors.lastname: Lin
authors.forename: Shihong
authors.initials: S
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.forename: Zhenxing
authors.initials: Z
authors.lastname: Ma
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
mesh_terms: D000368:Aged; D044466:Asian People; D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012214:Rheumatic Heart Disease / Q000150:complications*; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*