Stroke recurrence within 2 years after ischemic infarction

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Stroke. 1991;22:155-161

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ARTICLES

Stroke recurrence within 2 years after ischemic infarction

DB Hier, MA Foulkes, M Swiontoniowski, RL Sacco, PB Gorelick, JP Mohr, TR Price and PA Wolf
University of Illinois, Chicago.

We prospectively studied stroke recurrence in 1,273 patients with ischemic stroke who were entered into the Stroke Data Bank. Median follow-up was 13 months. The 2-year cumulative recurrence rate among these patients was 14.1%. Age, sex, race, history of hypertension, atrial fibrillation, or transient ischemic attacks, and stroke location were not associated with a higher risk of stroke recurrence. Patients with an elevated blood pressure, an abnormal initial computed tomogram, or a history of diabetes mellitus were at a higher risk of stroke recurrence. In contrast, patients with an infarct of unknown cause were at a lower risk of stroke recurrence than patients with a defined stroke mechanism, such as lacune, embolism, or atherosclerosis. A multivariate model suggests that patients at the lowest risk for stroke recurrence have a low diastolic blood pressure, no history of stroke, no history of diabetes mellitus, and an infarct of unknown cause.

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				R. L. Sacco, R. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, et al. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Circulation, March 14, 2006; 113(10): e409 - e449. [Abstract] [Full Text] [PDF]

				H. Zhou, D. J.M. Isaman, S. Messinger, M. B. Brown, R. Klein, M. Brandle, and W. H. Herman A Computer Simulation Model of Diabetes Progression, Quality of Life, and Cost Diabetes Care, December 1, 2005; 28(12): 2856 - 2863. [Abstract] [Full Text] [PDF]

				C. Jackson and C. Sudlow Comparing risks of death and recurrent vascular events between lacunar and non-lacunar infarction Brain, November 1, 2005; 128(11): 2507 - 2517. [Abstract] [Full Text] [PDF]

				G Tsivgoulis, K Spengos, N Zakopoulos, E Manios, K Xinos, D Vassilopoulos, and K N Vemmos Twenty four hour pulse pressure predicts long term recurrence in acute stroke patients J. Neurol. Neurosurg. Psychiatry, October 1, 2005; 76(10): 1360 - 1365. [Abstract] [Full Text] [PDF]

				K. I. Paraskevas, S. S. Daskalopoulou, M. E. Daskalopoulos, and C. D. Liapis Secondary Prevention of Ischemic Cerebrovascular Disease. What Is the Evidence? Angiology, September 1, 2005; 56(5): 539 - 552. [Abstract] [PDF]

				J Hata, Y Tanizaki, Y Kiyohara, I Kato, M Kubo, K Tanaka, K Okubo, H Nakamura, Y Oishi, S Ibayashi, et al. Ten year recurrence after first ever stroke in a Japanese community: the Hisayama study J. Neurol. Neurosurg. Psychiatry, March 1, 2005; 76(3): 368 - 372. [Abstract] [Full Text] [PDF]

				W. N. Kernan, C. M. Viscoli, S. E. Inzucchi, L. M. Brass, D. M. Bravata, G. I. Shulman, and J. C. McVeety Prevalence of Abnormal Glucose Tolerance Following a Transient Ischemic Attack or Ischemic Stroke Arch Intern Med, January 24, 2005; 165(2): 227 - 233. [Abstract] [Full Text] [PDF]

				D.-W. Kang, L. L. Latour, J. A. Chalela, J. A. Dambrosia, and S. Warach Early and late recurrence of ischemic lesion on MRI: Evidence for a prolonged stroke-prone state? Neurology, December 28, 2004; 63(12): 2261 - 2265. [Abstract] [Full Text] [PDF]

				S. C. Johnston and J. D. Easton Are Patients With Acutely Recovered Cerebral Ischemia More Unstable? Stroke, October 1, 2003; 34(10): 2446 - 2450. [Abstract] [Full Text] [PDF]

				T. Hillen, C. Coshall, K. Tilling, A. G. Rudd, R. McGovern, and C. D.A. Wolfe Cause of Stroke Recurrence Is Multifactorial: Patterns, Risk Factors, and Outcomes of Stroke Recurrence in the South London Stroke Register Stroke, June 1, 2003; 34(6): 1457 - 1463. [Abstract] [Full Text] [PDF]

				J.-C. Corvol, A. Bouzamondo, M. Sirol, J.-S. Hulot, P. Sanchez, and P. Lechat Differential Effects of Lipid-Lowering Therapies on Stroke Prevention: A Meta-analysis of Randomized Trials Arch Intern Med, March 24, 2003; 163(6): 669 - 676. [Abstract] [Full Text] [PDF]

				G. Lancaster, C. J. Lovoulos, M. Moussouttas, A. H. Goldstein, D. Leifer, P. B. Fayad, D. Olsen, and J. A. Elefteriades Aortic arch replacement for recurrent cerebral embolization Ann. Thorac. Surg., January 1, 2002; 73(1): 291 - 294. [Abstract] [Full Text] [PDF]

				G. Staaf, A. Lindgren, and B. Norrving Pure Motor Stroke From Presumed Lacunar Infarct: Long-Term Prognosis for Survival and Risk of Recurrent Stroke Stroke, November 1, 2001; 32(11): 2592 - 2596. [Abstract] [Full Text] [PDF]

				T. J. Tegos, E. Kalodiki, S.-S. Daskalopoulou, and A. N. Nicolaides Stroke: Epidemiology, Clinical Picture, and Risk Factors: Part I of III Angiology, October 1, 2000; 51(10): 793 - 808. [Abstract] [PDF]

				J. Moncayo, G. Devuyst, G. Van Melle, and J. Bogousslavsky Coexisting Causes of Ischemic Stroke Arch Neurol, August 1, 2000; 57(8): 1139 - 1144. [Abstract] [Full Text] [PDF]

				E. Ahmed, B. Stegmayr, J. Trifunovic, L. Weinehall, G. Hallmans, and A. K. Lefvert Anticardiolipin Antibodies Are Not an Independent Risk Factor for Stroke : An Incident Case-Referent Study Nested Within the MONICA and Vasterbotten Cohort Project Stroke, June 1, 2000; 31(6): 1289 - 1293. [Abstract] [Full Text] [PDF]

				G. W. Petty, R. D. Brown Jr, J. P. Whisnant, J. D. Sicks, W. M. O'Fallon, and D. O. Wiebers Ischemic Stroke Subtypes : A Population-Based Study of Functional Outcome, Survival, and Recurrence Stroke, May 1, 2000; 31(5): 1062 - 1068. [Abstract] [Full Text] [PDF]

				C. A. Derby, K. L. Lapane, H. A. Feldman, and R. A. Carleton Trends in Validated Cases of Fatal and Nonfatal Stroke, Stroke Classification, and Risk Factors in Southeastern New England, 1980 to 1991 : Data From the Pawtucket Heart Health Program Stroke, April 1, 2000; 31(4): 875 - 881. [Abstract] [Full Text] [PDF]

				W. N. Kernan, C. M. Viscoli, L. M. Brass, R. W. Makuch, P. M. Sarrel, and R. I. Horwitz Blood Pressure Exceeding National Guidelines Among Women After Stroke Stroke, February 1, 2000; 31(2): 415 - 419. [Abstract] [Full Text] [PDF]

				P. A. Wolf, G. P. Clagett, J. D. Easton, L. B. Goldstein, P. B. Gorelick, M. Kelly-Hayes, R. L. Sacco, and J. P. Whisnant Preventing Ischemic Stroke in Patients With Prior Stroke and Transient Ischemic Attack : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association Stroke, September 1, 1999; 30(9): 1991 - 1994. [Full Text] [PDF]

				J. Pniewski and B. Szyluk Ischemic Stroke in Poland and the United States Stroke, April 1, 1999; 30(4): 894 - 895. [Full Text] [PDF]

				J.F. Potter What should we do about blood pressure and stroke? QJM, February 1, 1999; 92(2): 63 - 66. [Full Text] [PDF]

				G. P. Samsa, J. Bian, J. Lipscomb, and D. B. Matchar Epidemiology of Recurrent Cerebral Infarction : A Medicare Claims�Based Comparison of First and Recurrent Strokes on 2-Year Survival and Cost Stroke, February 1, 1999; 30(2): 338 - 349. [Abstract] [Full Text] [PDF]

				L. N. Joseph, V. L. Babikian, N. C. Allen, and M. R. Winter Risk Factor Modification in Stroke Prevention : The Experience of a Stroke Clinic Stroke, January 1, 1999; 30(1): 16 - 20. [Abstract] [Full Text] [PDF]

				G. J. Hankey, K. Jamrozik, R. J. Broadhurst, S. Forbes, P. W. Burvill, C. S. Anderson, and E. G. Stewart-Wynne Long-Term Risk of First Recurrent Stroke in the Perth Community Stroke Study Stroke, December 1, 1998; 29(12): 2491 - 2500. [Abstract] [Full Text] [PDF]

				J. T. Moroney, E. Bagiella, M. C. Paik, R. L. Sacco, and D. W. Desmond Risk Factors for Early Recurrence After Ischemic Stroke : The Role of Stroke Syndrome and Subtype Stroke, October 1, 1998; 29(10): 2118 - 2124. [Abstract] [Full Text] [PDF]

				H. Yamamoto and J. Bogousslavsky Mechanisms of second and further strokes J. Neurol. Neurosurg. Psychiatry, June 1, 1998; 64(6): 771 - 776. [Abstract] [Full Text] [PDF]

				M. Prencipe, F. Culasso, M. Rasura, A. Anzini, M. Beccia, M. Cao, F. Giubilei, and C. Fieschi Long-term Prognosis After a Minor Stroke : 10-Year Mortality and Major Stroke Recurrence Rates in a Hospital-Based Cohort Stroke, January 1, 1998; 29(1): 126 - 132. [Abstract] [Full Text] [PDF]

				N. A. Obuchowski, M. T. Modic, M. Magdinec, and T. J. Masaryk Assessment of the Efficacy of Noninvasive Screening for Patients With Asymptomatic Neck Bruits Stroke, July 1, 1997; 28(7): 1330 - 1339. [Abstract] [Full Text]