Abstract 98: Stroke Recurrence Rates are Not Changing over Time
Background: Previous studies reported that recurrence rates after first ischemic stroke did not change from 1950 to 1989. We hypothesized that advances in secondary stroke prevention since 1990 would lead to a decrease in recurrence rates. We present the first population-based assessment of stroke recurrence rates over time since 1989.
Methods: We identified all hospitalized strokes during 4 study periods (7/93-6/94 and calendar years 1999, 2005, and 2010) among residents of the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) region (pop. 1.3M) by screening ICD9 codes of all inpatient and emergency department visits. Cases were abstracted by study nurses and verified by study physicians. Results for 2010 are preliminary. Among patients with initial ischemic strokes, we identified recurrent strokes, defined as any stroke (ischemic or hemorrhagic) that occurred after 14 days of the index stroke or that occurred within 14 days in a different vascular territory. Recurrence rates were calculated by Kaplan-Meier life-table analysis.
Results: We identified 6858 index strokes and 284 recurrent strokes, of which 19 (6.7%) were intracerebral hemorrhages. The table shows the proportion of recurrent strokes in each of the 4 study periods at various times after the index stroke. Mean follow-up times ranged from 147 to 170 days. We found no statistically significant difference in recurrence rates in the GCNKSS population over the 4 study periods.
Conclusions: Despite several advancements in recurrent stroke prevention, we found no change in stroke recurrence rates over 4 study periods between 1993/94 and 2010 within our large, biracial population. Compared with stroke risk after TIA, the risk of recurrent stroke is relatively low within the first 30 days, but gradually increases over time. Further studies are needed to characterize the utilization of secondary stroke prevention methods within this population.
Author Disclosures: I. Lee: None. H. Sucharew: Research Grant; Significant; NS30678. K. Alwell: Research Grant; Significant; NS30678. C.J. Moomaw: Research Grant; Significant; NS30678. D. Woo: Research Grant; Modest; NS30678. S. Ferioli: Research Grant; Modest; NS30678. P. Khatri: Honoraria; Modest; Academic Grand Rounds (paid to Dept). Other; Modest; Taylor and Francis-Stroke Ctr Handbook book royalties (paid to Dept). Research Grant; Significant; NIH/NINDS (IMS III, NSTN NCC/RCC). Other Research Support; Significant; Significant; Genentech-PRISMS Trial PI (paid to Dept), Penumbra-THERAPY Trial PI (paid to Dept). M. Flaherty: Research Grant; Modest; NS30678. O. Adeoye: Research Grant; Modest; NS30678. J. Mackey: None. S. Martini: Research Grant; Modest; NS30678. F. de los Rios La Rosa: None. J.P. Broderick: Other Research Support; Significant; PRISMS STUDY. D. Kleindorfer: Research Grant; Significant; NS30678. B. Kissela: Research Grant; Significant; NS30678.
- © 2014 by American Heart Association, Inc.