Stroke, Vol 22, 305-311, Copyright © 1991 by American Heart Association
RL Sacco, WA Hauser, JP Mohr and MA Foulkes
Little is known about outcome after cerebral infarction for different
ethnic groups. Of 590 stroke patients hospitalized from 1983 to 1986 at the
Neurological Institute, cerebral infarction over age 39 years occurred in
135 whites, 177 blacks, and 82 Hispanics. Outcome after cerebral infarction
differed by ethnicity. The 1-month mortality rate was similar in whites and
blacks and least in Hispanics. Whites had a slightly greater risk of
recurrent stroke or death than blacks or Hispanics until 6 months after
infarction, when their risk stabilized, while the risk in blacks and
Hispanics continued to rise for the entire year of follow-up. By 1 year,
the rate of recurrent stroke or death was 34.8 +/- 4.2% in whites, 31.1 +/-
3.6% in blacks, and 21.4 +/- 4.8% in Hispanics (p = 0.04). Differences were
found in the distribution of various stroke risk factors in the three
ethnic groups. A Cox proportional hazards model demonstrated that the
ethnic differences in stroke risk factors and infarct subtype were
responsible for the ethnic differences in outcome. An abnormal first
electrocardiogram was a risk factor for stroke recurrence or death in all
three ethnic groups, while a nonlacunar infarct subtype and a history of
diabetes were significant only in Hispanics. Understanding the associations
of stroke determinants with ethnicity may lead to more focused secondary
prevention of recurrent stroke.
ARTICLES
One-year outcome after cerebral infarction in whites, blacks, and Hispanics
Neurological Institute, Columbia-Presbyterian Medical Center, New York, N.Y.
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