Abstract TP219: Two-Year Recurrence After First-Ever Stroke in a General Population of 1.4 Million Japanese: Shiga Stroke Registry

Abstract

Introduction: Despite many effective strategies for the secondary prevention of stroke, individuals who survived an initial stroke have been shown to be at high risk of recurrent stroke. The aim of the present analysis is to investigate the current status of stroke recurrence after first-ever stroke using data from a large-scale population-based stroke registry in Japan. Methods: Shiga Stroke Registry is an ongoing population-based registry of stroke, which covers approximately 1.4 million residents of the Shiga prefecture in central Japan (located central part of Honshu Island). There is an integrated surveillance system involving the registration of cases among a network of all acute care hospitals with neurology/neurosurgery facilities and smaller hospitals with rehabilitation facilities. A total of 2,176 first-ever stroke cases (1,398 cerebral infarction, 551 intracerebral hemorrhage, 227 others), who were registered in 2011, were followed up till December 2013. We defined recurrence as any type of stroke after 28days from the onset of index event. The 2-year cumulative recurrence rates were estimated using Kaplan-Meier method for total stroke cases and according to gender or subtypes of index stroke. The study has been approved by the Institutional Review Board of Shiga University of Medical Science. Results: During a 2-year follow up period, 57 patients experienced recurrent stroke and 646 patients died without recurrence. One-year and two-year crude cumulative recurrence rates after first-ever stroke were 1.8% and 3.4%, respectively. Two-year crude cumulative recurrence rates were similar for men and women (3.4% vs 3.5%). Two-year crude cumulative recurrence rate was higher in patients with prior cerebral infarction (4.3%) than that in those with prior intracerebral hemorrhage (2.0%). Conclusions: In the present population-based stroke registry with real-world setting in Japan, 2-year cumulative recurrence rate after first-ever stroke is still high, particularly among patients with a history of cerebral infarction. More intensive secondary prevention strategies are required for these high-risk individuals.