The main factors affecting the long-term outcomes in patients after acute cerebrovascular disorder: results of the LIS-2 study

Abstract

Aim. To evaluate the long-term prognosis of life in patients after cerebral stroke (MI) and to identify the main factors influencing it. Material and methods. All patients (n=960) who had MI or transient ischemic attack in the period from 01.01.2009 to 31.12.2011, admitted to Lyubertsy district hospital №2, were included into the register of LIS-2. The primary endpoint was total mortality of patients. Results. The average age of patients was 72±9 years, 2/3 were women. 207 patients (21.7%) died in the hospital, 753 were discharged from the hospital. Median follow-up was 2.8 (2.1, 3.5) years. 31.5% of the patients died during this period. The main cause of death (36%) was re-MI, and 22.4% of patients died from the heart failure. The relative risk (RR) of death was significantly increased with the age of patients (RR=1.1). The probability of death increased in the presence of diabetes mellitus (RR=1.4), alcohol abuse (RR=2.3), any signs of consciousness disorders in the acute phase of MI (RR=1.6), heart failure (RR=1.6), atrial fibrillation (RR=1.4). Patients who were treated with calcium channel blockers before admission to the hospital, had a lower risk of death than those who did not receive these drugs (RR=0.4). Prescription of ACE inhibitors at discharge from the hospital reduced significantly the risk of death in the long-term period (RR=0.7). Conclusion. High rate of long-term mortality in the LIS-2 register can be largely explained by the poor quality of primary and secondary prevention of cardiovascular events.