Recurrence after a First- ever Ischemic Stroke Development of a Clinical Prediction Rule

Cámara, Agustı́n Gómez de la; Varona, José Felipe; dVivas, Paloma Ferrando; Guzmán, Jaime; Pozo, Silvia Vazquez Fernandez del; dCuadrado, Agustin Rivero; Pareja, Félix Bermejo

doi:10.5171/2013.264063

Cited by 10 publications

(11 citation statements)

References 44 publications

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“…In the 16 studies identified the cumulative risk of stroke recurrence in 9115 patient survivors are as follows: 3.1% at 30 days, 11.1% at 1 year, 26.4% at 5 years and 39.2% at 10 years. Our results are consistent with the previous finding that the risk of stroke recurrence is highest in the first year following a first ever-ischemic stroke [4][5][6]. In this study, the odds of a stroke recurrence in the first year after the index stroke is 2.4 times higher than in subsequent years.…”

Section: Discussionsupporting

confidence: 93%

“…It has been reported in hospital-based data that the over-all risk of stroke recurrence within five years after a first episode is approximately between 15-40% [3,4]. Within the first year after the initial stroke, the risk of stroke recurrence is higher (between 6-14%) as opposed to risk in subsequent years (4% annually) [4][5][6]. The maximum incidence of recurrent stroke is in the first 30 days after initial stroke [7].…”

Section: Introductionmentioning

confidence: 99%

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Recurrence Rate of Ischemic Stroke: A Single Center Experience

Jc¹

2017

Austin J Cerebrovasc Dis & Stroke

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Recurrence Rate of Ischemic Stroke: A Single Center Experience

Jc¹

2017

Austin J Cerebrovasc Dis & Stroke

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“…Patients with diabetes are two to three times more likely to have ischemic stroke when compared with nondiabetic individuals [28] . Diabetes mellitus was associated with 26.25% of ischemic stroke [29] .…”

Section: Alemayehu and Birhanesilasiementioning

confidence: 99%

“…Twelve of our patients had ischemic heart disease with eight patients having atrial fibrillation. Atrial fibrillation is arguably the most important cardiac risk factor for stroke [29] .…”

Section: Alemayehu and Birhanesilasiementioning

confidence: 99%

A Comparison between Intracranial and Extracranial Arteries Using Neuroimaging in Acute Ischemic Stroke and Its Relation to Risk Factors

Zayat

Fawzy

Zaki

et al. 2020

International Journal of Medical Arts

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Background: Atherosclerotic infarction accounts for a sizable proportion of cerebral infarcts whether occurs from extracranial or intracranial atherosclerotic disease. Despite recent studies on stroke risk factors; it is still unclear whether or not single risk factor specifically affect extracranial or intracranial arteries in stroke patients. Aim of the work: To determine the difference between intracranial and extracranial steno-occlusive atherosclerosis and its correlation with risk factors of acute ischemic stroke using Magnetic Resonance Angiogram (MRA) and/or Computed Tomography Angiography (CTA) with Duplex. Patients and methods: All cases diagnosed as acute ischemic stroke were subjected to detailed history, full neurological examination, routine laboratory tests, extracranial vessels assessed by duplex, intracranial vessels assessed by MRA and/or CTA. Results: 61 patients included in the study (38 males and 23 females), with mean age (64.5 ± 11.4). Extracranial stenosis was (57 patients, 93.4%), while intracranial stenosis was (49 patients, 80.3%). But the intracranial significant stenosis was (45 patients, 73.77%), while the extracranial significant stenosis (26 patients, 42.62%). Hypertension (72.1%), obesity (62.3%), diabetes (57.4%), dyslipidemia (54.1%) and smoking (39.3%), were risk factors equally affecting the extracranial and the intracranial systems in the same descending order. There was a higher prevalence of hypertension among patients with intracranial significant stenosis showing a significant P-value of 0.048. Conclusion: Extracranial stenosis was more common than the intracranial stenosis, but the intracranial significant stenosis is more prevalent than the extracranial. Hypertension is a significant risk factor for intracranial significant stenosis.

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“…Patients with a recent ischemic stroke are at risk for a second ischemic stroke with reported 1-year-incidence rates ranging from 8% to 14% [1][2][3]. In contrast to patients with transient ischemic attack (TIA), predictors of recurrent ischemic stroke in patients with a recent ischemic stroke are less well known.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Imaging Predictors of Recurrent Ischemic Stroke: A Systematic Review and Meta-Analysis

et al. 2018

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Background: Predictors of recurrent ischemic stroke are less well known in patients with a recent ischemic stroke than in patients with transient ischemic attack (TIA). We identified clinical and radiological factors for predicting recurrent ischemic stroke in patients with recent ischemic stroke. Methods: A systematic search in PubMed, Embase, Cochrane Library, and CINAHL was performed with the terms “ischemic stroke,” “predictors/determinants,” and “recurrence.” Quality assessment of the articles was performed and the level of evidence was graded for the articles included for the meta-analysis. Pooled risk ratios (RR) and heterogeneity (I²) were calculated using inverse variance random effects models. Results: Ten articles with high-quality results were identified for meta-analysis. Past medical history of stroke or TIA was a predictor of recurrent ischemic stroke (pooled RR 2.5, 95% CI 2.1–3.1). Small vessel strokes were associated with a lower risk of recurrence than large vessel strokes (pooled RR 0.3, 95% CI 0.1–0.7). Patients with stroke of an undetermined cause had a lower risk of recurrence than patients with large artery atherosclerosis (pooled RR 0.5, 95% CI 0.2–1.1). We found no studies using CT or ultrasound for the prediction of recurrent ischemic stroke. The following MRI findings were predictors of recurrent ischemic stroke: multiple lesions (pooled RR 1.7, 95% CI 1.5–2.0), multiple stage lesions (pooled RR 4.1, 95% CI 3.1–5.5), multiple territory lesions (pooled RR 2.9, 95% CI 2.0–4.2), chronic infarcts (pooled RR 1.5, 95% CI 1.2–1.9), and isolated cortical lesions (pooled RR 2.2, 95% CI 1.5–3.2). Conclusions: In patients with a recent ischemic stroke, a history of stroke or TIA and the subtype large artery atherosclerosis are associated with an increased risk of recurrent ischemic stroke. Predictors evaluated with MRI include multiple ischemic changes and isolated cortical lesions. Predictors of recurrent ischemic stroke concerning CT or ultrasound have not been published.

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Recurrence after a First- ever Ischemic Stroke Development of a Clinical Prediction Rule

Abstract: Background: Cumulative risk of stroke recurrence is about 26% at five years, with overall mortality rate of 38%.

Cited by 10 publications

References 44 publications

Recurrence Rate of Ischemic Stroke: A Single Center Experience

Recurrence Rate of Ischemic Stroke: A Single Center Experience

A Comparison between Intracranial and Extracranial Arteries Using Neuroimaging in Acute Ischemic Stroke and Its Relation to Risk Factors

Clinical and Imaging Predictors of Recurrent Ischemic Stroke: A Systematic Review and Meta-Analysis

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