Abstract WP332: Recurrent Ischemic Stroke: Patient Characteristics, Hospital Arrival Mode, And Outcomes, Paul Coverdell National Acute Stroke Program 2016-18

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sallyann Coleman King ◽  
Erika Odom ◽  
Xin Tong
Keyword(s):  
Ischemic Stroke ◽  
Health Care Professionals ◽  
Recurrent Events ◽  
Recurrent Stroke ◽  
Patient Characteristics ◽  
Hospital Death ◽  
Stroke Patients ◽  
Severe Stroke ◽  
Black Patients ◽  
Public Health Practitioners

Introduction: Better characterizing patients with recurrent ischemic stroke, whether they are more likely to arrive by ambulance, and their outcomes is important to reinforcing prevention practices and identifying disparities. Method: We identified 226,974 admissions with a clinical diagnosis of ischemic stroke, age≥18 years, from 463 participating hospitals in the PCNASP from 2016-2018, 58,505 or 25.8% of which had a recurrent stroke. We compared descriptive and clinical features of those with a first stroke with those having recurrent stroke. Results: A higher proportion of recurrent stroke admissions was found among black (vs. white) patients: 32.2% vs 24.3%). Recurrent stroke patients were more likely to arrive by ambulance (52.8% vs 45.0%), suffer a more severe stroke (mean NIHSS 6.8 vs 5.9) and less likely to receive alteplase (7.9% vs 10.9%) than those with their first stroke. In addition, those with a recurrent stroke were also more likely to have worse outcomes with fewer recurrent stroke patients being discharged home (42.7% vs 51%). Small differences were seen in the proportion of recurrent stroke patients who were able to ambulate with assistance before their stroke but were then unable to ambulate at discharge (2.2% vs 0.9% for first stroke patients). There were no significant differences seen for in-hospital death. Conclusion: Black patients with ischemic strokes had a higher proportion of recurrent events. Recurrent stroke patients were more likely to arrive by ambulance, and suffer a more severe stroke and have worse outcomes. Understanding disparities among those with recurrent stroke may support public health practitioners and health care professionals intervene to prevent or manage recurrent stroke.

Abstract WP286: Race and Gender Differences Among Patients With First or Recurrent Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Mary G George ◽  
Xin Tong
Keyword(s):  
Gender Differences ◽  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Hospital Death ◽  
Stroke Severity ◽  
Race And Gender ◽  
Black Females ◽  
White Males ◽  
Black Patients ◽  
And Gender

Introduction: Little information is known about the race and gender differences in stroke severity of acute ischemic stroke (AIS) among those presenting with and without a recurrent stroke (RS). Methods: The study is limited to white and black patients who were admitted with an AIS in the Paul Coverdell National Acute Stroke Program from 2012-2014. There were 157 967 admissions from 453 hospitals identified. After excluding those with missing NIHSS (33 017), the analysis focused on 124 950 patients. Results: The median age of blacks and females was greater than for whites and males, 74 vs 63 and 75 vs 68, respectively. RS accounted for 21.8% of AIS in white males, 21.2% in white females, 28.3% in black males, and 30.0% in black females. The median NIHSS was higher among females with initial stroke or RS stroke (4.0 vs 3.0 and 5.0 vs 4.0, respectively, p<0.0001) and higher among blacks with initial stroke or RS (4.0 vs 3.0 and 5.0 vs 4.0, respectively, p<0.0001). Overall in-hospital death was greater among whites and females compared to blacks and males (4.1% vs 2.9%, p<0.0001; 4.2% vs 3.5%, p<0.0001, respectively), and this pattern was consistent for initial AIS and RS. Use of tPA was greater among whites and males compared to blacks and females (11.6% vs 10.3%, p<0.0001; 11.5 vs 11.1%, p=0.02, respectively). This pattern was consistent for initial AIS and RS by race and for initial AIS by gender, but not for tPA for RS by gender. Females and blacks were less likely to have a mild stroke (NIHSS score 0-4) than males and whites for both initial and RS (p<0.0001). After adjusting for age, state, hospital, and year, the odds of having an NIHSS ≥5 was 16% lower among males, 36% greater among blacks, and 38% greater for those with a RS (data not shown). Conclusion: Race and gender differences on age, stroke severity, receipt of tPA, and in-hospital death among initial AIS patients persist for RS. Blacks, females, and those with a RS have more severe AIS.

Abstract MP86: Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Acute Ischemic Stroke Patients by History of Hypertension and Use of Antihypertensive Medications

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Tan Xu ◽  
Yonghong Zhang ◽  
Yingxian Sun ◽  
Chung-Shiuan Chen ◽  
Jing Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
Hospital Discharge ◽  
Odds Ratio ◽  
Recurrent Stroke ◽  
Stroke Patients ◽  
Antihypertensive Medications ◽  
History Of

Introduction: The effects of blood pressure (BP) reduction on clinical outcomes among acute stroke patient remain uncertain. Hypothesis: We tested the effects of immediate BP reduction on death and major disability at 14 days or hospital discharge and 3-month follow-up in acute ischemic stroke patients with and without a previous history of hypertension or use of antihypertensive medications. Methods: The China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) randomly assigned patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP) to receive antihypertensive treatment (N=2,038) or to discontinue all antihypertensive medications (N=2,033) during hospitalization. Randomization was stratified by participating hospitals and use of antihypertensive medications. Study outcomes were assessed at 14 days or hospital discharge and 3-month post-treatment follow-up. The primary outcome was death and major disability (modified Rankin Scale score≥3), and secondary outcomes included recurrent stroke and vascular events. Results: Mean SBP was reduced 12.7% in the treatment group and 7.2% in the control group within 24 hours after randomization (P<0.001). Mean SBP was 137.3 mmHg in the treatment group and 146.5 in the control group at day 7 after randomization (P<0.001). At 14 days or hospital discharge, the primary and secondary outcomes were not significantly different between the treatment and control groups by subgroups. At the 3-month follow-up, recurrent stroke was significantly reduced in the antihypertensive treatment group among patients with a history of hypertension (odds ratio 0.43, 95% CI 0.24-0.75, P=0.003) and among patients with a history of use of antihypertensive medications (odds ratio 0.41, 95% CI 0.20-0.84, P=0.01). All-cause mortality (odds ratio 2.84, 95% CI 1.11-7.27, P=0.03) was increased among patients without a history of hypertension. Conclusion: Immediate BP reduction lowers recurrent stroke among acute ischemic stroke patients with a previous history of hypertension or use of antihypertensive medications at 3 months. On the other hand, BP reduction increases all-cause mortality among patients without a history of hypertension.

Abstract P132: Clinical Outcomes In Ischemic Stroke Patients With Uncontrolled Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Zahra Abuzaid ◽  
Sara Almuslem ◽  
Farah Aleisa
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Recurrent Stroke ◽  
Uncontrolled Hypertension ◽  
Stroke Recurrence ◽  
Stroke Patients ◽  
Stroke Event ◽  
Uncontrolled Blood Pressure

Background: Hypertension is considered major risk factor for incidence of ischemic stroke, controlling blood pressure reduces this risk, the relationship of uncontrolled blood pressure and stroke outcomes is complex, post stroke uncontrolled blood pressure remains one of the major contributing factors for stroke recurrence and mortality, in our study we studied the long term effects of uncontrolled hypertension in modern health care setting. Methodology: Patients in the study were admitted to the neurology department at KFSH-D between March 2015- August 2019, we included 102 acute ischemic stroke patients whom had hypertension, all patients had follow up appointments at stroke clinic a minimum of 2 visits over 4 years. We retrospectively compared blood pressure data from stroke patients with recurrent ischemic stroke events vs. patients with initial stroke event, and recurrent stroke, also we studied blood pressure readings for different stroke severity groups, patients who had severe stroke with mRS>4, compared to milder stroke group of mRS<4. Results: We found 48 patients identified with recurrent stroke event, those with uncontrolled hypertension had significantly higher stroke recurrence events (P=0.002), despite acute stroke treatment, patients who had history of uncontrolled hypertension were found to have more severe stroke deficits than those who had controlled blood pressure (P=0.029). We found significant difference in the long term stroke clinical outcomes between patients who had uncontrolled blood pressure and patients who had controlled blood pressure recordings within the same hospital setting (P=0.064). Conclusion: Based on our findings, uncontrolled hypertension was associated with higher risk of stroke recurrence, it also increased susceptibility to worse stroke clinical outcomes up to 1 year after initial stroke event, which deserved further close attention and better blood pressure control.

scholarly journals Lipid Profile in New and Recurrent Ischemic Stroke Patients at Haji General Hospital of North Sumatra Indonesia

2019 ◽  
Vol 3 (3) ◽  
pp. 146
Author(s):  
Meizly Andina ◽  
Lisa Nabila Pratiwi ◽  
Fadhilah Ramadhan Aribowo
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Lipid Profile ◽  
General Hospital ◽  
Recurrent Stroke ◽  
Secondary Data ◽  
Ischemic Stroke Patient ◽  
Stroke Patients ◽  
Average Value ◽  
North Sumatra

Introduction: Stroke refers to any sudden neurological disorder that occurs due to the cessation of blood flow through the arterial supply system of the brain. The etiology obstructions are atherosclerosis. There was an imbalance of lipid profiles in patients with ischemic stroke There was an imbalance of lipid profiles in patients with ischemic stroke. The objective of this research is to determine differences between lipid profile in new ischemic stroke patients with recurrent stroke at Haji General Hospital of North Sumatra Indonesia in 2015-2016.Methods: This is a cross-sectional study using total sampling method with a total of 64samples. Secondary data obtained from General hospital Haji Medan. Secondary data collected were data on lipid profile in patients with acute stroke and recurrent stroke by collecting medical records.Results: The result from the acute stroke patients found HDL levels of 33.97 mg/dl, recurrent stroke patients found HDL levels of 35.25 mg/dl. LDL levels in acute stroke patients were 109.56 mg/dl and recurrent stroke patients were 123.16 mg/dl. In new ischemic stroke patient, the average value of triglyceride levels was 143 mg/dl and the average value of total cholesterol was 205.8 mg/ dl. In recurrent ischemic stroke patient, the average value of triglyceride levels was 165.2 mg/dl and the mean total cholesterol level was 180.8 mg/dl.Discussion: There are no differences of lipid profile in new and recurrent ischemic stroke patients at Haji General Hospital of North Sumatra Indonesia in 2015-2016 (p>0.05)International Journal of Human and Health Sciences Vol. 03 No. 03 July’19. Page: 146-149

scholarly journals Admission blood glucose and in-hospital clinical outcome among patients with acute stroke in Inner Mongolia, China

2009 ◽  
Vol 32 (2) ◽  
pp. 151 ◽  
Author(s):  
Ning Wang ◽  
Dawei Qiao ◽  
Weijun Tong ◽  
Fengshan Zhang ◽  
Zhong Ju ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Glucose ◽  
Acute Stroke ◽  
Inner Mongolia ◽  
Odds Ratio ◽  
Logistic Model ◽  
Hemorrhagic Stroke ◽  
Blood Glucose Concentration ◽  
Hospital Death ◽  
Stroke Patients

Purpose: There is still controversy about the association between admission blood glucose concentration and outcome of acute stroke. We studied the association between admission blood glucose and in-hospital death / dependency among acute stroke patients in Inner Mongolia, China. Methods: 2,178 acute ischemic and 1,760 hemorrhagic stroke patients in six hospitals were included in the study. Blood glucose and other study variables were collected within the first 24-hr of hospital admission. Clinical outcomes were evaluated by neurologists during hospitalization. The associations between admission blood glucose and the risk of in-hospital death/dependency were analyzed using a multiple logistic model. Results: There were associations between admission blood glucose and in-hospital death/dependency among patients with acute ischemic or hemorrhagic stroke. Compared with patients with blood glucose < 6.1mmol/L, multivariate-adjusted odds ratio (95% confidence interval) of death/dependency were 0.53 (0.23, 1.27), 2.22 (1.21, 4.11), 1.92 (1.12, 3.33) and 1.91 (1.00, 3.64) for ischemic stroke patients, and 0.93 (0.44, 1.96), 1.42 (0.65, 3.10), 1.98 (1.10, 3.55) and 2.93 (1.40, 6.11) for hemorrhagic stroke patients, with blood glucose 6.1-6.9, 7.0-7.7, 7.8-11.0 and ?11.1mmol/L, respectively. Conclusion: Increased admission blood glucose was associated with death/dependency among patients with acute hemorrhagic and ischemic stroke.

Cancer-Associated Hypercoagulation Increases the Risk of Early Recurrent Stroke in Patients with Active Cancer

2018 ◽  
Vol 46 (1-2) ◽  
pp. 46-51 ◽  
Author(s):  
Jun Fujinami ◽  
Tomoyuki Ohara ◽  
Fukiko Kitani-Morii ◽  
Yasuhiro Tomii ◽  
Naoki Makita ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Recurrent Stroke ◽  
Stroke Recurrence ◽  
Multivariable Logistic Regression Analysis ◽  
Stroke Patients ◽  
Recurrent Cancer ◽  
Systemic Metastasis ◽  
D Dimer ◽  
Active Cancer

Background: This study assessed the incidence and predictors of short-term stroke recurrence in ischemic stroke patients with active cancer, and elucidated whether cancer-associated hypercoagulation is related to early recurrent stroke. Methods: We retrospectively enrolled acute ischemic stroke patients with active cancer admitted to our hospital between 2006 and 2017. Active cancer was defined as diagnosis or treatment for any cancer within 12 months before stroke onset, known recurrent cancer or metastatic disease. The primary clinical outcome was recurrent ischemic stroke within 30 days. Results: One hundred ten acute ischemic stroke patients with active cancer (73 men, age 71.3 ± 10.1 years) were enrolled. Of those, recurrent stroke occurred in 12 patients (11%). When patients with and without recurrent stroke were compared, it was found that those with recurrent stroke had a higher incidence of pancreatic cancer (33 vs. 10%), systemic metastasis (75 vs. 39%), multiple vascular territory infarctions (MVTI; 83 vs. 40%), and higher ­D-dimer levels (16.9 vs. 2.9 µg/mL). Multivariable logistic regression analysis showed that each factor mentioned above was not significantly associated with stroke recurrence independently, but high D-dimer (hDD) levels (≥10.4 µg/mL) and MVTI together were significantly associated with stroke recurrence (OR 6.20, 95% CI 1.42–30.7, p = 0.015). Conclusions: Ischemic stroke patients with active cancer faced a high risk of early recurrent stroke. The concurrence of hDD levels (≥10.4 µg/mL) and MVTI was an independent predictor of early recurrent stroke in active cancer patients. Our findings suggest that cancer-associated hypercoagulation increases the early recurrent stroke risk.

410 Sleep and Stroke: Improved OSA Time to Diagnosis for Stroke Patients Using an Inpatient Diagnostic and Treatment Strategy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A163-A163
Author(s):  
Sree Naik ◽  
Ramin Zand ◽  
Nada El Andary ◽  
Anne Marie Morse
Keyword(s):  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Recurrent Stroke ◽  
Statistical Significance ◽  
Screening Method ◽  
Stroke Patients ◽  
Stroke Population ◽  
Obstructive Sleep ◽  
Time To Diagnosis ◽  
Home Sleep Apnea Testing

Abstract Introduction Obstructive sleep apnea (OSA) is an independent risk for development of stroke. Despite this known relationship there is insufficient screening of sleep apnea in many recognized stroke centers, including Geisinger. In 2016, 68 patients were admitted to Geisinger Wyoming Valley (GWV) with ischemic stroke. Less than 10% had a Sleep Medicine Referral. When referred, average time to CPAP initiation was 9–12 months. An ongoing quality improvement (QI) study implemented inpatient home sleep apnea testing (HSAT) for stroke patients and subsequent autoPAP, if positive. Interim analysis demonstrates high rates of OSA using this screening method, suggesting a viable mechanism for improved time to OSA diagnosis. Methods All patients at GWV evaluated by neurology due to acute neurologic change were considered for enrollment (9/1/2019-10/10/2020). Only patients 18 years and older hospitalized with diagnosis of ischemic stroke were included. Patients were consented for participation. The evening of enrollment an Alice NightOne HSAT device was applied by a respiratory technician. If OSA was identified, the patient was placed on APAP the following evening. Results A total of 302 patients were screened with 82 patients meeting criteria for enrollment (27%) and 64 consenting for participation and attempting HSAT (21%). 18 of the 82 (22%) eligible patients refused participation. 12 patients (19%) had insufficient HSAT studies to determine OSA diagnosis. Of the patients who successfully completed an adequate HSAT study 85% (44/52) had OSA identified. Conclusion OSA is highly prevalent in patients with ischemic stroke and represents a modifiable risk factor for recurrent stroke. At baseline, rate of and time to diagnosis of OSA was poor with less than 10% of stroke patients receiving a sleep referral and time to initiation of CPAP was approximately 1 year. Standard universal in hospital surveillance for OSA using an HSAT in admitted stroke patients appears to allow for an increased rate of capture, but perhaps also a shorter time to diagnosis. This data may also suggest that prevalence of OSA in this stroke population is similar to slightly higher than previously reported. Further analysis of this program is required to evaluate for statistical significance and impact of APAP use. Support (if any) Geisinger Health Plan

Abstract WP359: Microembolic Signals Are Associated With Stroke Readmission in Patients With Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Nasir Fakhri ◽  
Simin Mahinrad ◽  
Arth Srivastava ◽  
Eric Liotta ◽  
Richard Bernstein ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Incidence Rates ◽  
High Risk Population ◽  
Stroke Patients ◽  
Entire Cohort ◽  
Cox Proportional Hazard ◽  
Stroke Population ◽  
Cox Proportional Hazard Models ◽  
Ischemic Attack

Background: Microembolic signals (MES) identified by transcranial Doppler (TCD) are strong predictors of recurrent stroke in patients with carotid disease. In this study, we investigated the association of MES with transient ischemic attack (TIA) or stroke readmission among ischemic stroke patients. Methods: We included a total of 789 patients (mean age 62±17 years, 55% male) who were consecutively admitted to Northwestern Memorial hospital with a diagnosis of stroke. All patients who underwent TCD studies within the first 48 hours of admission were included. Using an electronic database warehouse, patients were followed during 12 months for any hospital readmission due to ischemic stroke or TIA. Risk of stroke readmission was estimated using multivariate Cox proportional hazard models. Results: MES were detected in 95 patients on admission. During 12 months of follow-up, incidence rates for stroke and TIA readmission, and stroke readmission alone were 23.0 and 7.0 per 100 person-years across the entire cohort, respectively. In multivariate adjusted models, patients with MES, as compared to patients without MES, had 1.80-fold (95% CI=1.07, 2.53; p =0.008) higher risk of stroke and TIA readmission, and 2.30-fold (95% CI=1.13, 4.67, p =0.021) higher risk of readmission due to stroke alone. Conclusion: We showed that the presence of MES early after stroke admission is associated with higher risk of stroke and TIA readmission in stroke patients. This not only highlights the importance of identifying MES in the stroke population upon first admission, but also the need to further identify and implement therapeutic strategies to reduce stroke burden and prevent readmission in this high-risk population.

Abstract 3730: Length Of Hospitalization And Discharge Disposition Among Acute Ischemic Stroke Patients With Moderate To Severe Stroke by Treatment

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Steven A Koehler ◽  
Maxim Hammer ◽  
Vivek Reddy ◽  
Houhammad Jumaa ◽  
Syed Zaidi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Acute Ischemic Stroke ◽  
Treatment Modality ◽  
Cerebral Arteries ◽  
Stroke Patients ◽  
Term Care ◽  
Severe Stroke ◽  
Discharge Disposition ◽  
Significant Difference

Background: Data regarding length of stay and discharge disposition in patients with moderate to severe stroke are scarce. We sought to determine Length of Stay (LoS) in a consecutive group of patients admitted at a large academic center and assess for any possible difference in LoS at discharge by treatment modality received and by vessels occlusion status. Methods: Retrospective review of a database comprising acute ischemic stroke patients admitted to our center between 1/1/2009-3/31/2011. Patient Demographics, treatment modality (IV thrombolytic tissue plasminogen activator (IVtPA), Endovascular (IA), no thrombolytic (NT), LoS, occlusion of major cerebral arteries and discharge disposition were collected. Inclusion criteria were AIS with admission NIHSS ≥10. Results: A total of 744 patients 361 (48.5%) male, mean age 69.9 years were identified. Treatment modalities: 174 (23%) IVtPA, 177 (24%) IA, 393 (53%) NT. Median NIHSS 16.5 and not significant among the 3 groups (P=.603). Mean LoS was 7.38 days (SD 7.4) with no significant difference between the 3 groups (P=.056). Occlusion to one of the 3 cerebral arteries (ICA, MCA, BA) was: 84% in IVtPA, 100% in IA, 87% in NT. Discharge disposition and LoS by treatment and occlusions are shown in the Table . Among patients treated with IVtPA (n=174) mean LoS was 6.33 days (range 1-27). LoS was significantly longer among those without occlusion vs with any occlusion (P=.001). Among patients that received IA (n=177) mean LoS was 8.21 days (range 0-74). Among patients received NT (n=393) the mean LoS was 7.47 days (range 0-64). Conclusions: Thrombolytic therapy (IV or EV) in patients with strokes is not associated with longer hospitalizations duration. A significant difference between death rates in patients receiving IA thrombolytic (22%) compared to IV (32%) or NT (30%) was found with fewer death among those that received IA (P= .008). Patients discharged to long term care facilities have regardless of treatment longer LoS (12.41v 6.14) (P>.000).

Abstract T P388: Statin Use is Linked to Lower Risk of Recurrent Vascular Events among Ischemic Stroke Patients with Atrial Fibrillation

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Meng Lee ◽  
Yi-Ling Wu ◽  
Jeffrey L Saver ◽  
Jiann-Der Lee ◽  
Hui-Hsuan Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Recurrent Stroke ◽  
Stroke Patients ◽  
Antithrombotic Agent ◽  
Vascular Events ◽  
Index Stroke ◽  
Statin Use

Background: The efficacy of statin therapy in the prevention of recurrent stroke and major adverse cardiovascularevents (MACE) was clearly established by the SPARCL trial; but SPARCL excluded patients whose index stroke was due to a presumed cardioembolic mechanism. As such, it remains unclear whether statins are beneficial in cardioembolic stroke patients, particularly those with atrial fibrillation (AF). Objective: To evaluate the relationship between statin use and future vascular risk reduction among recent ischemic stroke patients with AF Methods: We analyzed the Taiwan National Health Insurance registry which comprises beneficiaries aged ≥ 18 years. Code ICD-9 was used to identify a primary hospitalization diagnosis of ischemic stroke and AF among subjects encountered between 2003 and 2009. Follow-up was from time of the index stroke to admission for recurrent stroke or myocardial infarction; withdrawal from the registry; and last medical claim before 1/1/2011. Patients were divided into 2 groups based on whether statin was prescribed (at least 30 days vs. never used) during the follow-up period. Patients were excluded if they did not take any antithrombotic agent within 30 days before an endpoint. Primary endpoint was MACE (composite of stroke and myocardial infarction) and a key secondary endpoint was any recurrent stroke. Multivariate-adjusted hazard ratio (HR) and 95% CI for the development of events were estimated using Cox models. Model was adjusted for baseline age, gender, hypertension, diabetes, prior stroke, prior myocardial infarction, hyperlipidemia, hospital level, and antithrombotic agent during follow-up. Results: Among 4455 eligible patients, mean age was 71 years and mean follow-up duration was 2.8 years.Compared to non-statin use, statin use was associated with a significantly lower occurrence of MACE (adjusted HR 0.84, 95% CI 0.72 to 0.99, P=0.04) and recurrent stroke (adjusted HR 0.82, 0.69 to 0.97, P=0.02). Statin use was also linked to lower ischemic stroke risk, but had neutral effects on intracranial hemorrhage and myocardial infarction. Conclusion: Among patients with an index ischemic stroke and AF, statin use is associated with a lower risk of recurrent vascular events including stroke.

Sign in / Sign up

Export Citation Format

Share Document