Risk factors for early and late recurrent ischemic strokes

Hassan Mohammed Elnady,Ahmed Borai,Gharib Fawi Mohammed,Hazem Kamal Elhewag,Mohamed Khodery Mohamed

doi:10.1186/s41983-020-00190-3

Hassan Mohammed Elnady, Ahmed Borai + Show 3 more

Open Access

https://doi.org/10.1186/s41983-020-00190-3

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Abstract

BackgroundNationally, information regarding risk factors for early and late recurrence of ischemic stroke is limited.ObjectivesThe aim of this study was to identify the risk factors for early and late recurrent ischemic stroke.Patients and methodsWe prospectively compared data from 58 patients with early (within 1 year after the index stroke) recurrent ischemic stroke with 64 patients with late (1 year or more after the index stroke) recurrent ischemic stroke. Patients in the study were admitted to the Department of Neurology and Psychological Medicine, Sohag University Hospital, in the period between April 2017 and August 2017. The etiology of recurrent stroke was determined according to the TOAST classification. The presence of vascular risk factors was registered and compared in both groups.ResultsSystolic blood pressure was significantly higher among those with late recurrence compared to those with early recurrence (p = 0.026). Patients with early recurrent ischemic stroke were more likely to be aphasic (p = 0.047). Regarding the TOAST classification, small vessel disease and undetermined etiology were significantly higher among patients with late recurrence, while cardioembolism and large artery atherosclerosis were significantly higher among those with early recurrence (p = 0.008).ConclusionPatients with large artery atherosclerosis and cardioembolism are at increased risk of early recurrence and warrant special efforts for secondary prevention.

Highlights

Cerebrovascular stroke is the 5th cause of death in the First World countries [1]
Regarding the TOAST classification, small vessel disease and undetermined etiology were significantly higher among patients with late recurrence, while cardioembolism and large artery atherosclerosis were significantly higher among those with early recurrence (p = 0.008)
Patients with large artery atherosclerosis and cardioembolism are at increased risk of early recurrence and warrant special efforts for secondary prevention

Summary

Introduction

Cerebrovascular stroke is the 5th cause of death in the First World countries [1]. Up to 25% of the total number of strokes occurring annually in the USA are recurrent strokes [2]. Following advancements in primary and secondary preventive care, the incidence of recurrent stroke is high. For Western countries, the first 5year cumulative incidence of stroke recurrence ranges from 16 to 30% [3,4,5]. As the risk of recurrent stroke is most prominent in the first few months after stroke, it is important to identify factors associated with early recurrence in order to establish effective treatments for secondary stroke prevention [7]. The aim of this study was to identify the risk factors for early and late recurrent ischemic stroke. Information regarding risk factors for early and late recurrence of ischemic stroke is limited

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Conclusion