Cumulative risk of stroke recurrence over the last 10years: a systematic review and meta-analysis.

Abstract

Stroke is still the main cause of death and disability worldwide, numerous studies of recurrence risk have been reported, while systematic estimates of stroke recurrence risk in the last 10years are variable. This review aims to estimate the cumulative stroke recurrence risk in the last 10years for secondary prevention management in future. A systematic search from January 2009 to March 2019 was conducted through PubMed, EMBASE, Web of Science, Wan-fang, and CNKI. Search terms were in English and Chinese. A total of 37 studies involving 1,075,014 stroke patients were included. The pooled stroke recurrence rate was 7.7% at 3months, 9.5% at 6months, 10.4% at 1year, 16.1% at 2years, 16.7% at 3years, 14.8% at 5years, 12.9% at 10years, and 39.7% at 12years after the initial stroke. In addition, the pooled recurrence rate of 32 studies including stroke patients over 50years only at seven time points except for subgroup of 10years was 7.7%, 9.5%, 11.2%, 16.1%, 19.3%, 18.1%, and 39.7%, respectively. Meta-regression showed that the time points explained 23.02% of the variance among studies, while regions, age, and stroke types showed no significant contribution to heterogeneity. The risk of stroke recurrence varies greatly from 3months to over 10years and increases significantly over time in both young and old subgroup. The heterogeneity may be explained by follow-up time, regions, age, methodology differences, and stroke types, which was needed further exploration in future.