Kyusik Kang1, Tai Hwan Park2, Nayoung Kim3, Min Uk Jang4, Sang-Soon Park2, Jong-Moo Park1, Youngchai Ko5, SooJoo Lee5, Kyung Bok Lee6, Jun Lee7, Dong-Eog Kim8, Yong-Jin Cho9, Joon-Tae Kim10, Dae-Hyun Kim11, Jae-Kwan Cha11, Moon-Ku Han3, Ji Sung Lee12, Juneyoung Lee13, Mi Sun Oh14, Jay Chol Choi15, Byung-Chul Lee14, Keun-Sik Hong16, Hee-Joon Bae17. 1. Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea. 2. Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea. 3. Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 4. Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea. 5. Department of Neurology, Eulji University Hospital, Daejeon, Republic of Korea. 6. Department of Neurology, Soonchunhyang University Hospital, Seoul, Republic of Korea. 7. Department of Neurology, Yeungnam University Hospital, Daegu, Republic of Korea. 8. Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea. 9. Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea. 10. Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea. 11. Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea. 12. Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea. 13. Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea. 14. Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea. 15. Department of Neurology, Jeju National University Hospital, Jeju, Republic of Korea. 16. Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea. Electronic address: nrhks@paik.ac.kr. 17. Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: braindoc@snu.ac.kr.
Abstract
BACKGROUND: Patients with acute ischemic stroke (AIS) are at high risk of subsequent vascular events. The aim of this study was to estimate rates of recurrent stroke, myocardial infarction (MI), and major vascular events during the first year after AIS in Korea. METHODS: Through a multicenter stroke registry in Korea, 12,227 consecutive cases of AIS were identified between November 2010 and May 2013 and were followed up for recurrent stroke, MI, and major vascular events up to 1 year after stroke. RESULTS: Cumulative 30-day, 90-day and 1-year rates were 2.7%, 3.9%, and 5.7% for recurrent stroke; .1%, .3%, and .5% for MI; and 8.1%, 10.6%, and 13.7% for major vascular events, indicating that the early period is at high risk of recurrent stroke and major vascular events. The risk of recurrent stroke was substantially higher than the risk of MI: 13.0 times at 90 days and 11.4 times at 1 year. Compared to those with small-vessel occlusion (SVO), those with ischemic stroke subtypes other than SVO had a higher risk of recurrent stroke as well as major vascular events. Other common independent predictors for recurrent stroke and major vascular events were diabetes and prior stroke history. CONCLUSIONS: During the first year after AIS, one in 18 had recurrent stroke and one in 7 major vascular events. More than two thirds of recurrent stroke and three quarters of major vascular events developed within 90 days in a Korean cohort of stroke patients. Better prevention strategies are required for high-risk patients during this high-risk period.
BACKGROUND:Patients with acute ischemic stroke (AIS) are at high risk of subsequent vascular events. The aim of this study was to estimate rates of recurrent stroke, myocardial infarction (MI), and major vascular events during the first year after AIS in Korea. METHODS: Through a multicenter stroke registry in Korea, 12,227 consecutive cases of AIS were identified between November 2010 and May 2013 and were followed up for recurrent stroke, MI, and major vascular events up to 1 year after stroke. RESULTS: Cumulative 30-day, 90-day and 1-year rates were 2.7%, 3.9%, and 5.7% for recurrent stroke; .1%, .3%, and .5% for MI; and 8.1%, 10.6%, and 13.7% for major vascular events, indicating that the early period is at high risk of recurrent stroke and major vascular events. The risk of recurrent stroke was substantially higher than the risk of MI: 13.0 times at 90 days and 11.4 times at 1 year. Compared to those with small-vessel occlusion (SVO), those with ischemic stroke subtypes other than SVO had a higher risk of recurrent stroke as well as major vascular events. Other common independent predictors for recurrent stroke and major vascular events were diabetes and prior stroke history. CONCLUSIONS: During the first year after AIS, one in 18 had recurrent stroke and one in 7 major vascular events. More than two thirds of recurrent stroke and three quarters of major vascular events developed within 90 days in a Korean cohort of strokepatients. Better prevention strategies are required for high-risk patients during this high-risk period.
Authors: Wenxian Sun; Luyang Zhang; Weishi Liu; Mengke Tian; Xin Wang; Jing Liang; Yuying Wang; Lan Ding; Lulu Pei; Jie Lu; Yuming Xu; Bo Song Journal: Int J Gen Med Date: 2021-12-09