title: Recurrent stroke was associated with poor quality of life in patients with transient ischemic attack or minor stroke: finding from the CHANCE trial.
abstract: OBJECTIVE
  To examine the health-related quality of life (HRQOL) in patients with transient ischemic attack (TIA) or minor stroke and assess the impact of recurrent stroke on HRQOL.
  
  
  METHODS
  Health-related quality of life data on patients participated in the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial were analyzed. The available 90-day EuroQoL data (EQ-5D) were used to calculate EQ-5D index score. Poor HRQOL was defined as an EQ-5D index score ≤0.5. The characteristics of HRQOL and factors predicting poor HRQOL in these patients were then explored.
  
  
  RESULTS
  Among the total 5170 patients enrolled, 90-day HRQOL data were obtained from 5104 patients for analysis. The mean EQ-5D index score at day 90 was 0.88 ± 0.21 for all patients, but only 0.42 ± 0.35 for those with recurrent strokes. Poor 90-day HRQOL was found in 294 (5.8%) patients. Patients with poor HRQOL had more strokes during follow-up than patients with good HRQOL (94.9 vs. 4.7%, P < 0.001). Age, history of hypertension and diabetes, and NIHSS at baseline were independent risk factors for predicting poor HRQOL. Stroke recurrence, NIHSS at baseline, age, and minor stroke on admission became independent risk factors once stroke recurrence was added into the model.
  
  
  CONCLUSIONS
  Stroke recurrence was associated with poor HRQOL in patients with TIA or minor strokes. Interventions focusing on controlling risk factors and prevention of worsening of neurological function may prevent poor HRQOL in these patients.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Yue-Song
authors.initials: YS
authors.lastname: Pan
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhao
authors.forename: David
authors.initials: D
authors.lastname: Wang
authors.forename: S Claiborne
authors.initials: SC
authors.lastname: Johnston
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Liu
authors.forename: Xia
authors.initials: X
authors.lastname: Meng
authors.forename: An-Xin
authors.initials: AX
authors.lastname: Wang
authors.forename: Chun-Xue
authors.initials: CX
authors.lastname: Wang
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000523:psychology*; D016896:Treatment Outcome
keywords: EQ-5D; Health outcomes; Quality of life; Stroke; Transient ischemic attack