Clinical risk factors associated with recurrence of ischemic stroke within two years

Abstract

To identify the clinical risk factors and investigate the efficacy of a classification model based on the identified factors for predicting 2-year recurrence after ischemic stroke. From June 2017 to January 2019, 358 patients with first-ever ischemic stroke were enrolled and followed up in Shenzhen Traditional Chinese Medicine Hospital. Demographic and clinical characteristics were recorded by trained medical staff. The outcome was defined as recurrence within 2 years. A multivariate logistic regression model with risk factors and their interaction effects was established and evaluated. The mean (standard deviation) age of the participants was 61.6 (12.1) years, and 101 (28.2%) of the 358 patients were female. The common comorbidities included hypertension (286 patients, 79.9%), diabetes (148 patients, 41.3%), and hyperlipidemia (149 patients, 41.6%). The 2-year recurrence rate was 30.7%. Of the 23 potential risk factors, 10 were significantly different between recurrent and non-recurrent subjects in the univariate analysis. A multivariate logistic regression model was developed based on 10 risk factors. The significant variables include diabetes mellitus, smoking status, peripheral artery disease, hypercoagulable state, depression, 24 h minimum systolic blood pressure, 24 h maximum diastolic blood pressure, age, family history of stroke, NIHSS score status. The area under the receiver operating characteristic curve (ROC) was 0.78 (95% confidence interval: 0.726–0.829) with a sensitivity of 0.61 and a specificity of 0.81, indicating a potential predictive ability. Ten risk factors were identified, and an effective classification model was built. This may aid clinicians in identifying high-risk patients who would benefit most from intensive follow-up and aggressive risk factor reduction. The clinical trial registration number: ChiCTR1800019647

Traditional risk factors and combined genetic markers of recurrent ischemic stroke in adults

“…21,22 According to literature findings, this link was proven in our cohort. 13,23 In addition to the above factors, the level of disability is a significant risk factor of second stroke. A mild neurological deficit was significantly associated with recurrent stroke event in our young populations.…”

Investigation of Risk Factors in Recurrent Stroke

“…İnme geçiren hastalardaki risk faktörlerinin araştırılması, tekrarlayan inmelerin önlenmesi ve tedavisinde çok önemlidir. 14 Tüm inme tipleri için en önemli değiştirilemez risk faktörü olan yaş, aynı zamanda tekrarlayan inmenin önemli bağımsız belirleyicilerinden biridir. Literatürde, inmenin tüm bireylerde 55 yaşından sonra her 10 yılda bir 2 katından fazla arttığı ve %65'inin, 65 yaşın üzerindekilerde görüldüğü tespit edilmiştir.…”

Clinical characteristics and radiological domains among patients with recurrent strokes-a descriptive cross-sectional study from a tertiary care center in central Nepal

“…Stroke is a significant global health hazard 7 . The continuum impact of the associated morbidity and mortality is mostly observed in low and middle-income nations 6 . With the concurrent increment in the lifespan of the population alongside adaptations of unhealthy lifestyle and living habits, the prevalence of stroke will certainly show an upward curve in the coming future 7 .…”

“…Current smokers were defined as those who have smoked ≥1 cigarette per day for 6 months and have smoked in the last 28 days, whereas heavy drinkers were labeled as those who have consumed >2 and >1 standard drink per day (a glass of wine, a bottle of beer, or a shot of spirits, ∼10 to 12 g of ethanol) for men or and women respectively 6 . Measurement of treatment adherence (compliance) was performed by the self reported and pills count methods.…”