engleski

Predictors of one-year stroke recurrence in the Northern Manhattan stroke study

As a part of the community-based Northern Manhattan Stroke Study, 611 patients with first cerebral infarction were prospectively followed to detect the 1-year stroke recurrence. Baseline risk factors evaluated included age, gender, hypertension, diabetes, smoking, alcohol consuption, serum cholesterol, myocardial infarction, congestive heart failure (CHF), atrial fibrillation, and NIH stroke scale (NIHSS). Life tables were used to estimate the 1-year stroke recurrence risk, and a logistic multiple regression model to calculate relative risks and 95 percent CI one year after initial stroke. Among 94 (15 percent) patients with identified recurrence, 19 percent died within 1 year from recurrent stroke. The life table cumulative risk of recurrent stroke was 3 percent at day 30, 10 percent at 1 year, 14 percent at 2 years, and 18 percent at 3 years. The 1-year cumulative risk of recurrence did not significantly differ according to age or gender. The 1 year recurrence risk was significantly different for the baseline NIH stroke scale (NIHSS less than 3.5 percent, 3-8, 14 percent ; NIH over 8, 7 percent ; p=0.019) and CHF (yes 17 percent, no 19 percent ; p=0.041). The logistic multiple regression model revealed age over 60 years, CHF, and alcohol consuption of over 2 drinks/(day to be independent predictors of 1 year stroke recurrence (age over 60 RR 2.9, 95 percent CI 1.1-8.2 ; CHF RR 2.7, 1.3-5.5, alcohol over 2/day RR 3.1 CI 1.2-8.1). Our data suggest a different pattern of risk factors for stroke recurrence than that for initial stroke. The patients who have ačready suffered first stroke should also be considered a target population for education, improvement of compliance with medical therapies, and modification of hazardous behaviours.

stroke; recurrence; prognosis; cerebrovascular disorders; mortality

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