Risk stratification and prediction of recurrent stroke

Abstract

Approximately 30% of patients suffer a recurrent stroke during the 5 years after their first cerebrovascular event. Predictors differ for short- and long-term risk of stroke recurrence. Atherosclerotic disease is the single most important predictor for short-term recurrence, while most classical cardiovascular risk factors, as well as age, are independent predictors for long-term recurrence. Several prognostic models for long-term risk of recurrent stroke have been validated, but the predictive value and applicability of these models remains limited. However, an improved understanding of the risk for recurrent stroke is vital for the design of secondary prevention trials as well as individual treatment decisions, especially if the medication or procedure is expensive or risky. The aim of this article is to elucidate the relationship between stroke risk factors, prognostic scores and their predictive value in recurrent stroke.