Recurrent Stroke, Myocardial Infarction, and Major Vascular Events during the First Year after Acute Ischemic Stroke: The Multicenter Prospective Observational Study about Recurrence and Its Determinants after Acute Ischemic Stroke I

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• 作者：Kyusik Kang ; MD ; PhD^* ; Tai Hwan Park ; MD ; PhD^&dagger ; ; Nayoung Kim ; MD^&Dagger ; ; Min Uk Jang ; MD^§ ; ; Sang-Soon Park ; MD^&dagger ; ; Jong-Moo Park ; MD ; PhD^* ; Youngchai Ko ; MD^‖ ; SooJoo Lee ; MD ; PhD^‖ ; Kyung Bok Lee ; MD ; PhD^¶ ; ; Jun Lee ; MD ; PhD^# ; Dong-Eog Kim ; MD ; PhD^** ; Yong-Jin Cho ; MD ; PhD^&dagger ; &dagger ; ; Joon-Tae Kim ; MD ; PhD^&Dagger ; &Dagger ; ; Dae-Hyun Kim ; MD ; PhD^§ ; § ; ; Jae-Kwan Cha ; MD ; PhD^§ ; § ; ; Moon-Ku Han ; MD ; PhD^&Dagger ; ; Ji Sung Lee ; PhD^‖‖ ; Juneyoung Lee ; PhD^¶ ; ¶ ; ; Mi Sun Oh ; MD ; PhD^## ; Jay Chol Choi ; MD ; PhD^*** ; Byung-Chul Lee ; MD ; PhD^## ; Keun-Sik Hong ; MD ; PhD^&dagger ; &dagger ; ; ^{nrhks@paik.ac.kr" class="auth_mail" title="E-mail the corresponding author} ; Hee-Joon Bae ; MD ; PhD^&Dagger ; ; ^{braindoc@snu.ac.kr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Ischemic stroke ; myocardial infarction ; recurrence ; stroke subtype ; vascular death ; vascular event
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：25
• 期：3
• 页码：656-664
• 全文大小：256 K

文摘

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.