Trends in risk of recurrence after the first ischemic stroke in adults younger than 55 years of age in Sweden

Giang, Kok Wai; Björck, Lena; Stahl, Christina; Nielsen, Susanne; Sandström, Tatiana Zverkova; Jern, Christina; Rosengren, Annika

doi:10.1177/1747493015607519

Cited by 24 publications

(16 citation statements)

References 28 publications

(44 reference statements)

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“…Findings from a nationwide register of stroke patients suggest that the reduction in the risk of stroke recurrence observed over time was mainly due to the decrease in the early risk of stroke recurrence. In contrast, temporal trends of the long‐term risk of recurrence showed no significant variation over time 21. However, this study was subjected to selection bias in that only young patients were included.…”

Section: Discussionmentioning

confidence: 95%

Long‐Term Risk of Myocardial Infarction Compared to Recurrent Stroke After Transient Ischemic Attack and Ischemic Stroke: Systematic Review and Meta‐Analysis

Boulanger

Béjot

Rothwell

et al. 2018

JAHA

126

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BackgroundUncertainties remain about the current risk of myocardial infarction (MI) after ischemic stroke or transient ischemic attack.Methods and ResultsWe undertook a systematic review to estimate the long‐term risk of MI, compared to recurrent stroke, with temporal trends in ischemic stroke/transient ischemic attack patients. Annual risks and 95% confidence intervals (95% CI) of MI and recurrent stroke were estimated using random‐effect meta‐analyses. We calculated incidence ratios of MI/recurrent stroke, for fatal and nonfatal events, using similar analyses. Rate ratios for MI in patients with potential risk factors compared to those without were calculated using Poisson regression.A total of 58 studies (131 299 patients) with a mean (range) follow‐up of 3.5 (1.0‐10.0) years were included. The risk of MI was 1.67%/y (95% CI 1.36‐1.98, P het<0.001 for heterogeneity) and decreased over time (P int=0.021); 96% of the heterogeneity between studies was explained by study design, study period, follow‐up duration, mean age, proportion of patients on antithrombotic therapy, and incident versus combined ischemic stroke/transient ischemic attack. The risk of recurrent stroke was 4.26%/y (95% CI 3.43‐5.09, P het<0.001), with no change over time (P int=0.63). The risk of fatal MI was half the risk of recurrent strokes ending in fatality (incidence ratio=0.51, 95% CI 0.14‐0.89, P het=0.58). The risk of nonfatal MI was 75% smaller than the risk of recurrent nonfatal stroke (incidence ratio=0.25, 95%CI 0.02‐0.50, P het=0.68). Male sex, hypertension, coronary and peripheral artery diseases were associated with a doubled risk of MI.ConclusionsAfter ischemic stroke/transient ischemic attack, the risk of MI is currently <2%/y, and recurrent stroke is a more common cause of death than MI.

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Section: Discussionmentioning

confidence: 95%

Long‐Term Risk of Myocardial Infarction Compared to Recurrent Stroke After Transient Ischemic Attack and Ischemic Stroke: Systematic Review and Meta‐Analysis

Boulanger

Béjot

Rothwell

et al. 2018

JAHA

126

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“…A few previous studies also demonstrated trends in the incidence of recurrent stroke. The 4-year cumulative risk of recurrent IS in Sweden was 11.8% in men and 9.8% in women during a 5-year period (2002–2006) [10]; the values from previous studies were slightly lower [9,17,18]. According to another Swedish study, the risk of recurrent IS decreased by 55%over time in younger stroke patients [32].…”

Section: Discussionmentioning

confidence: 99%

Trends in the incidence of recurrent stroke at 5 years after the first-ever stroke in rural China: a population-based stroke surveillance from 1992 to 2017

Zhao

Liu

et al. 2019

Aging

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Recent data on the incidence and trends for recurrent strokes in China are scarce. We assessed the temporal trends in recurrent stroke incidence using in rural China. The age-standardized incidences of recurrent stroke, within 5 years of the incident stroke event, were estimated for 3 time periods: 1992–1998, 1999–2005, and 2006–2012. Among the 768 documented incident stroke cases, 26.3% of the patients experienced recurrent stroke within 5 years. The overall age-adjusted recurrent stroke incidence was 43.93 per 100,000 person-years (1992–2012). During the 2006–2012 period, the recurrent stroke incidence per 100,000 person-years was 107.79 in men, and 557.76 in individuals ≥65 years old. There were significant upward tendencies observed in this population across sex, age, or type of stroke (except for among individuals ≥65 years old with incident intracerebral hemorrhages). Compared with the recurrent stroke incidence observed in the 1992–1998 period, that observed during the 2006–2012 period was more than 3-fold higher; the greatest increase (6.8-fold) was observed in women. These findings suggest an urgent need to improve risk factor management and implement appropriate medical resources to contain this upward trend in recurrent stroke incidence and reduce the overall stroke burden in China.

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“…Previous investigations on recurrent strokes in young adults usually involve small sample sizes, making it difficult to study the long-term trend of stroke recurrence (Giang et al, 2016). Therefore, we performed a meta-analysis to clarify the inconsistencies between previous studies, and to establish a comprehensive picture of gene-disease associations.…”

Section: Discussionmentioning

confidence: 99%

Association between C807T(C/T) polymorphism of platelet glycoprotein gene and sensitivity to ischemic stroke: a meta-analysis

et al. 2017

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ABSTRACT. Ischemic stroke can lead to loss of neurologic functions. It occurs due to obstruction in blood supply to the brain. It has been proposed that C807T(C/T) polymorphism within the platelet glycoprotein gene may be associated with density and function of glycoprotein Ia/IIa receptors and contributes to the pathogenesis of thrombotic disease. We assessed the association between C807T(C/T) and risk of ischemic stroke. Databases such as PubMed, Medline, Springer, Elsevier Science Direct, Cochrane Library, Google scholar, Wanfang Data (Chinese), and Chinese National Knowledge Infrastructure (CNKI, Chinese) were used to search for relevant studies. We found 16 eligible studies, which totaled to 4897 (case group 2340; control group 2557) participants. Overall, our results showed significant associations between C807T(C/T) polymorphism and risk of ischemic stroke based on T-allele comparisons (T vs C, pooled OR = 0.78, 95%CI = 0.68-0.90, P < 0.01), TT vs CC comparisons (pooled OR = 0.58, 95%CI = 0.42-0.81, P < 0.01), recessive models (TT vs TC + CC, pooled OR = 0.72, 95%CI = 0.59-0.87, P < 0.01) and dominant models (TT + TC vs CC, pooled OR = 0.70, 95%CI = 0.54-0.92, P < 0.05). There was no association in TC vs CC comparisons (pooled OR = 0.81, 95%CI = 0.63-1.04, P > 0.05). Subgroup analyses stratified according to Hardy-Weinberg equilibrium, sample size, and ethnicity also demonstrated significant associations between the two variables. Therefore, C807T(C/T) polymorphism in the platelet glycoprotein gene may be associated with susceptibility to ischemic stroke, and the T allele at this locus may decrease risk to ischemic stroke.

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Trends in risk of recurrence after the first ischemic stroke in adults younger than 55 years of age in Sweden

Cited by 24 publications

References 28 publications

Long‐Term Risk of Myocardial Infarction Compared to Recurrent Stroke After Transient Ischemic Attack and Ischemic Stroke: Systematic Review and Meta‐Analysis

Long‐Term Risk of Myocardial Infarction Compared to Recurrent Stroke After Transient Ischemic Attack and Ischemic Stroke: Systematic Review and Meta‐Analysis

Trends in the incidence of recurrent stroke at 5 years after the first-ever stroke in rural China: a population-based stroke surveillance from 1992 to 2017

Association between C807T(C/T) polymorphism of platelet glycoprotein gene and sensitivity to ischemic stroke: a meta-analysis

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