Lisa Bergström1, Anna-Lotta Irewall2, Lars Söderström2, Joachim Ögren2, Katarina Laurell2, Thomas Mooe2. 1. From the Departments of Public Health and Clinical Medicine (L.B., J.Ö., A.-L.I., T.M.) and Pharmacology and Clinical Neuroscience (K.L.), Umeå University, Sweden; and Unit of Research, Development, and Education, Östersund Hospital, Sweden (L.S.). lisa.bergstrom@regionjh.se. 2. From the Departments of Public Health and Clinical Medicine (L.B., J.Ö., A.-L.I., T.M.) and Pharmacology and Clinical Neuroscience (K.L.), Umeå University, Sweden; and Unit of Research, Development, and Education, Östersund Hospital, Sweden (L.S.).
Abstract
BACKGROUND AND PURPOSE: Recent data on the incidence, time trends, and predictors of recurrent ischemic stroke are limited for unselected patient populations. METHODS: Data for ischemic stroke patients were obtained from The Swedish Stroke Register (Riksstroke) between 1998 and 2009 and merged with The Swedish National Inpatient Register. A reference group of patients was created by Statistics Sweden. The ischemic stroke patient cohort was divided into 4 time periods. Recurrent ischemic stroke within 1 year was recorded until 2010. Kaplan-Meier and Cox regression analyses were performed to study time trends and predictors of ischemic stroke recurrence. RESULTS: Of 196 765 patients with ischemic stroke, 11.3% had a recurrent ischemic stroke within 1 year. The Kaplan-Meier estimates of the 1-year cumulative incidence of recurrent ischemic stroke decreased from 15.0% in 1998 to 2001 to 12.0% in 2007 to 2010 in the stroke patient cohort while the cumulative incidence of ischemic stroke decreased from 0.7% to 0.4% in the reference population. Age >75 years, prior ischemic stroke or myocardial infarction, atrial fibrillation without warfarin treatment, diabetes mellitus, and treatment with β-blockers or diuretics were associated with a higher risk while warfarin treatment for atrial fibrillation, lipid-lowering medication, and antithrombotic treatment (acetylsalicylic acid, dipyridamole) were associated with a reduced risk of recurrent ischemic stroke. CONCLUSIONS: The risk of recurrent ischemic stroke decreased from 1998 to 2010. Well-known risk factors for stroke were associated with a higher risk of ischemic stroke recurrence; whereas, secondary preventive medication was associated with a reduced risk, emphasizing the importance of secondary preventive treatment.
BACKGROUND AND PURPOSE: Recent data on the incidence, time trends, and predictors of recurrent ischemic stroke are limited for unselected patient populations. METHODS: Data for ischemic strokepatients were obtained from The Swedish Stroke Register (Riksstroke) between 1998 and 2009 and merged with The Swedish National Inpatient Register. A reference group of patients was created by Statistics Sweden. The ischemic strokepatient cohort was divided into 4 time periods. Recurrent ischemic stroke within 1 year was recorded until 2010. Kaplan-Meier and Cox regression analyses were performed to study time trends and predictors of ischemic stroke recurrence. RESULTS: Of 196 765 patients with ischemic stroke, 11.3% had a recurrent ischemic stroke within 1 year. The Kaplan-Meier estimates of the 1-year cumulative incidence of recurrent ischemic stroke decreased from 15.0% in 1998 to 2001 to 12.0% in 2007 to 2010 in the strokepatient cohort while the cumulative incidence of ischemic stroke decreased from 0.7% to 0.4% in the reference population. Age >75 years, prior ischemic stroke or myocardial infarction, atrial fibrillation without warfarin treatment, diabetes mellitus, and treatment with β-blockers or diuretics were associated with a higher risk while warfarin treatment for atrial fibrillation, lipid-lowering medication, and antithrombotic treatment (acetylsalicylic acid, dipyridamole) were associated with a reduced risk of recurrent ischemic stroke. CONCLUSIONS: The risk of recurrent ischemic stroke decreased from 1998 to 2010. Well-known risk factors for stroke were associated with a higher risk of ischemic stroke recurrence; whereas, secondary preventive medication was associated with a reduced risk, emphasizing the importance of secondary preventive treatment.
Authors: Felizitas A Eichner; Christopher J Schwarzbach; Moritz Keller; Karl Georg Haeusler; Gerhard F Hamann; Dirk Sander; Heinrich J Audebert; Klaus Gröschel; Dieter Geis; Stephan von Bandemer; Viktoria Rücker; Martha Schutzmeier; Peter Ulrich Heuschmann; Armin Grau Journal: Eur Stroke J Date: 2020-03-12
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Authors: Shilpa Tyagi; Gerald Choon-Huat Koh; Luo Nan; Kelvin Bryan Tan; Helen Hoenig; David B Matchar; Joanne Yoong; Eric A Finkelstein; Kim En Lee; N Venketasubramanian; Edward Menon; Kin Ming Chan; Deidre Anne De Silva; Philip Yap; Boon Yeow Tan; Effie Chew; Sherry H Young; Yee Sien Ng; Tian Ming Tu; Yan Hoon Ang; Keng Hee Kong; Rajinder Singh; Reshma A Merchant; Hui Meng Chang; Tseng Tsai Yeo; Chou Ning; Angela Cheong; Yu Li Ng; Chuen Seng Tan Journal: BMC Health Serv Res Date: 2018-11-22 Impact factor: 2.655