Risk factors for early recurrence after ischemic stroke: The role of stroke syndrome and subtype

Joan T. Moroney, Emilia Bagiella, Myunghee C. Paik, Ralph L Sacco, David W. Desmond

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Background and Purpose - Information regarding risk factors for early recurrence is limited. Our aim was to identify the clinical predictors of early recurrence after ischemic stroke. Methods - We prospectively examined 297 patients (mean age, 72.0±8.4 years) hospitalized with ischemic stroke to identify recurrent strokes occurring within 90 days of the index stroke. Survival free of recurrence was estimated using Kaplan-Meier analysis stratified by demographic variables; vascular risk factors; stroke syndrome, subtype, vascular territory, and severity; scores on the Barthel Index and Mini-Mental State Examination during hospitalization; blood pressure on admission; and selected laboratory data. We estimated the relative risk (RR) of early recurrence associated with those variables using proportional hazards analysis. Results - We identified 22 recurrent events in the first 90 days after the index stroke, resulting in an early stroke recurrence rate of 7.4%, and death occurred immediately after recurrence in 6 of the 22 patients. A major hemispheric stroke syndrome (RR=2.9; 95% confidence interval [CI]=1.2 to 7.1), atherothrombotic stroke mechanism (RR=3.3; CI=1.3 to 8.3), and atrial fibrillation (RR=2.2; CI=0.8 to 6.1) were independent predictors of early recurrence, after adjustment for demographic variables. Conclusions - Early recurrence was frequent and resulted in increased mortality. Attention to the clinical features of the index stroke, including the presenting syndrome and the ischemic mechanism, and the recognition of atrial fibrillation may help in the selection of patients for the initiation of targeted interventions to prevent early recurrence and subsequent mortality.

Original languageEnglish
Pages (from-to)2118-2124
Number of pages7
JournalStroke
Volume29
Issue number10
StatePublished - Oct 1 1998
Externally publishedYes

Fingerprint

Stroke
Recurrence
Confidence Intervals
Atrial Fibrillation
Mortality
Demography
Kaplan-Meier Estimate
Patient Selection
Blood Vessels
Hospitalization
Blood Pressure
Survival

Keywords

  • Mortality
  • Risk factors
  • Stroke outcome
  • Stroke, ischemic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Moroney, J. T., Bagiella, E., Paik, M. C., Sacco, R. L., & Desmond, D. W. (1998). Risk factors for early recurrence after ischemic stroke: The role of stroke syndrome and subtype. Stroke, 29(10), 2118-2124.

Risk factors for early recurrence after ischemic stroke : The role of stroke syndrome and subtype. / Moroney, Joan T.; Bagiella, Emilia; Paik, Myunghee C.; Sacco, Ralph L; Desmond, David W.

In: Stroke, Vol. 29, No. 10, 01.10.1998, p. 2118-2124.

Research output: Contribution to journalArticle

Moroney, JT, Bagiella, E, Paik, MC, Sacco, RL & Desmond, DW 1998, 'Risk factors for early recurrence after ischemic stroke: The role of stroke syndrome and subtype', Stroke, vol. 29, no. 10, pp. 2118-2124.
Moroney JT, Bagiella E, Paik MC, Sacco RL, Desmond DW. Risk factors for early recurrence after ischemic stroke: The role of stroke syndrome and subtype. Stroke. 1998 Oct 1;29(10):2118-2124.
Moroney, Joan T. ; Bagiella, Emilia ; Paik, Myunghee C. ; Sacco, Ralph L ; Desmond, David W. / Risk factors for early recurrence after ischemic stroke : The role of stroke syndrome and subtype. In: Stroke. 1998 ; Vol. 29, No. 10. pp. 2118-2124.
@article{9fc23210e5b14f6eb702d03c2fee5a16,
title = "Risk factors for early recurrence after ischemic stroke: The role of stroke syndrome and subtype",
abstract = "Background and Purpose - Information regarding risk factors for early recurrence is limited. Our aim was to identify the clinical predictors of early recurrence after ischemic stroke. Methods - We prospectively examined 297 patients (mean age, 72.0±8.4 years) hospitalized with ischemic stroke to identify recurrent strokes occurring within 90 days of the index stroke. Survival free of recurrence was estimated using Kaplan-Meier analysis stratified by demographic variables; vascular risk factors; stroke syndrome, subtype, vascular territory, and severity; scores on the Barthel Index and Mini-Mental State Examination during hospitalization; blood pressure on admission; and selected laboratory data. We estimated the relative risk (RR) of early recurrence associated with those variables using proportional hazards analysis. Results - We identified 22 recurrent events in the first 90 days after the index stroke, resulting in an early stroke recurrence rate of 7.4{\%}, and death occurred immediately after recurrence in 6 of the 22 patients. A major hemispheric stroke syndrome (RR=2.9; 95{\%} confidence interval [CI]=1.2 to 7.1), atherothrombotic stroke mechanism (RR=3.3; CI=1.3 to 8.3), and atrial fibrillation (RR=2.2; CI=0.8 to 6.1) were independent predictors of early recurrence, after adjustment for demographic variables. Conclusions - Early recurrence was frequent and resulted in increased mortality. Attention to the clinical features of the index stroke, including the presenting syndrome and the ischemic mechanism, and the recognition of atrial fibrillation may help in the selection of patients for the initiation of targeted interventions to prevent early recurrence and subsequent mortality.",
keywords = "Mortality, Risk factors, Stroke outcome, Stroke, ischemic",
author = "Moroney, {Joan T.} and Emilia Bagiella and Paik, {Myunghee C.} and Sacco, {Ralph L} and Desmond, {David W.}",
year = "1998",
month = "10",
day = "1",
language = "English",
volume = "29",
pages = "2118--2124",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Risk factors for early recurrence after ischemic stroke

T2 - The role of stroke syndrome and subtype

AU - Moroney, Joan T.

AU - Bagiella, Emilia

AU - Paik, Myunghee C.

AU - Sacco, Ralph L

AU - Desmond, David W.

PY - 1998/10/1

Y1 - 1998/10/1

N2 - Background and Purpose - Information regarding risk factors for early recurrence is limited. Our aim was to identify the clinical predictors of early recurrence after ischemic stroke. Methods - We prospectively examined 297 patients (mean age, 72.0±8.4 years) hospitalized with ischemic stroke to identify recurrent strokes occurring within 90 days of the index stroke. Survival free of recurrence was estimated using Kaplan-Meier analysis stratified by demographic variables; vascular risk factors; stroke syndrome, subtype, vascular territory, and severity; scores on the Barthel Index and Mini-Mental State Examination during hospitalization; blood pressure on admission; and selected laboratory data. We estimated the relative risk (RR) of early recurrence associated with those variables using proportional hazards analysis. Results - We identified 22 recurrent events in the first 90 days after the index stroke, resulting in an early stroke recurrence rate of 7.4%, and death occurred immediately after recurrence in 6 of the 22 patients. A major hemispheric stroke syndrome (RR=2.9; 95% confidence interval [CI]=1.2 to 7.1), atherothrombotic stroke mechanism (RR=3.3; CI=1.3 to 8.3), and atrial fibrillation (RR=2.2; CI=0.8 to 6.1) were independent predictors of early recurrence, after adjustment for demographic variables. Conclusions - Early recurrence was frequent and resulted in increased mortality. Attention to the clinical features of the index stroke, including the presenting syndrome and the ischemic mechanism, and the recognition of atrial fibrillation may help in the selection of patients for the initiation of targeted interventions to prevent early recurrence and subsequent mortality.

AB - Background and Purpose - Information regarding risk factors for early recurrence is limited. Our aim was to identify the clinical predictors of early recurrence after ischemic stroke. Methods - We prospectively examined 297 patients (mean age, 72.0±8.4 years) hospitalized with ischemic stroke to identify recurrent strokes occurring within 90 days of the index stroke. Survival free of recurrence was estimated using Kaplan-Meier analysis stratified by demographic variables; vascular risk factors; stroke syndrome, subtype, vascular territory, and severity; scores on the Barthel Index and Mini-Mental State Examination during hospitalization; blood pressure on admission; and selected laboratory data. We estimated the relative risk (RR) of early recurrence associated with those variables using proportional hazards analysis. Results - We identified 22 recurrent events in the first 90 days after the index stroke, resulting in an early stroke recurrence rate of 7.4%, and death occurred immediately after recurrence in 6 of the 22 patients. A major hemispheric stroke syndrome (RR=2.9; 95% confidence interval [CI]=1.2 to 7.1), atherothrombotic stroke mechanism (RR=3.3; CI=1.3 to 8.3), and atrial fibrillation (RR=2.2; CI=0.8 to 6.1) were independent predictors of early recurrence, after adjustment for demographic variables. Conclusions - Early recurrence was frequent and resulted in increased mortality. Attention to the clinical features of the index stroke, including the presenting syndrome and the ischemic mechanism, and the recognition of atrial fibrillation may help in the selection of patients for the initiation of targeted interventions to prevent early recurrence and subsequent mortality.

KW - Mortality

KW - Risk factors

KW - Stroke outcome

KW - Stroke, ischemic

UR - http://www.scopus.com/inward/record.url?scp=0031712442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031712442&partnerID=8YFLogxK

M3 - Article

C2 - 9756592

AN - SCOPUS:0031712442

VL - 29

SP - 2118

EP - 2124

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 10

ER -