Risk factors for relapse and nomogram for relapse probability prediction in patients with minor ischemic stroke

Abstract Background: The incidences of stroke recurrence, disability, and all-cause death of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year percentage of stroke recurrence, disability, and all-cause death were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the percentage of stroke recurrence, disability, and all-cause death at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause death. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China, especially high percentage of disability. In this study, we found the risk factors affecting 1-year stroke recurrence, disability and, all-cause death which need further verification in the subsequent studies.

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PCV90 RISK FACTORS, USE OF HEALTH CARE RESOURCES, AND MORTALITY IN PATIENTS WITH MINOR ISCHEMIC STROKE OR HIGH-RISK TRANSIENT ISCHEMIC ATTACK

Value in Health ◽

10.1016/j.jval.2019.09.814 ◽

2019 ◽

Vol 22 ◽

pp. S558

Author(s):

O. Fasth ◽

P. Appelros ◽

B. Farahmand ◽

J. Hedberg ◽

P. Ladenvall ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Ischemic Stroke ◽

High Risk ◽

Transient Ischemic Attack ◽

Health Care Resources ◽

Minor Ischemic Stroke ◽

Ischemic Attack ◽

Use Of Health Care

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Risk factors for cervical atherosclerosis in patients with transient ischemic attack or minor ischemic stroke.

Stroke ◽

10.1161/01.str.24.7.970 ◽

1993 ◽

Vol 24 (7) ◽

pp. 970-975 ◽

Cited By ~ 25

Author(s):

H Palomäki ◽

M Kaste ◽

R Raininko ◽

O Salonen ◽

S Juvela ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Transient Ischemic Attack ◽

Minor Ischemic Stroke ◽

Ischemic Attack

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Evaluation of Risk Factors Associated with Stroke Recurrence in Patients with Minor Ischemic Stroke

Turkish Journal Of Neurology ◽

10.4274/tnd.2021.17992 ◽

2021 ◽

Author(s):

Yasemin Dinç ◽

Emel Oğuz Akarsu ◽

Bahattin Hakyemez ◽

Mustafa Bakar

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Stroke Recurrence ◽

Factors Associated ◽

Minor Ischemic Stroke

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Age in relation to comorbidity and outcome in patients with high-risk TIA or minor ischemic stroke: A Swedish national observational study

European Stroke Journal ◽

10.1177/2396987320975980 ◽

2020 ◽

pp. 239698732097598

Author(s):

Oskar Fasth ◽

Eva Lesén ◽

Peter Appelros ◽

Bahman Farahmand ◽

Jonatan Hedberg ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

High Risk ◽

Observational Study ◽

Vascular Risk Factors ◽

Stroke Severity ◽

Vascular Risk ◽

Vascular Events ◽

Risk Of Death ◽

Minor Ischemic Stroke

Introduction Recent trials report positive results for preventing vascular events with dual antiplatelet therapy (DAPT) in patients with high-risk TIA or minor ischemic stroke. We aimed to investigate this population regarding influence of age on vascular risk factors, hospital stay and mortality. Patients and methods Data on patients aged 40–100 years with TIA or ischemic stroke in the Swedish Stroke Register during 2012–13 were linked with national registers. To identify patients with high-risk TIA (ABCD2 ≥6) or minor ischemic stroke (NIHSS ≤5) eligible for DAPT, we excluded patients with atrial fibrillation, anticoagulant use, prior major bleeding, or unknown stroke severity. Findings We identified 10,053 potential DAPT-candidates (mean age 72.6 years, 45.2% female, 16.4% with TIA). With advancing age, most vascular risk factors increased. Antiplatelet treatment increased from 31.9% before the event to 95.5% after discharge. Within 1 year following index event, the proportion of patients with ≥1 re-admission increased with age (29.2% in 40–64 year-olds; 47.2% in 85–100 year-olds). All-cause death per 100 person-years was 6.9 (95% CI 6.4–7.4) within 1 year, and highest in the first 30 days (15.2; 95% CI 12.8–18.2). For each year of increased age, the risk of death increased with 3.5% (p = 0.128) in patients 40–64 years and with 11.8% (p < 0.001) in those ≥85 years. Conclusions While in theory representing a subset of patients with mild injury, our observational study highlights substantial use of health-care resources and high mortality rates among patients with high-risk TIA or minor ischemic stroke assumed eligible for DAPT.

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Sex differences in the risk of recurrent ischemic stroke after ischemic stroke and transient ischemic attack

European Stroke Journal ◽

10.1177/23969873211058568 ◽

2021 ◽

pp. 239698732110585

Author(s):

Elora Basu ◽

Setareh Salehi Omran ◽

Hooman Kamel ◽

Neal S Parikh

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Ischemic Stroke ◽

Stroke Risk ◽

Recurrent Stroke ◽

Minor Stroke ◽

Stroke Recurrence ◽

Stroke Risk Factors ◽

Minor Ischemic Stroke ◽

Using Data

Background Sex differences in stroke outcomes have been noted, but whether this extends to stroke recurrence is unclear. We examined sex differences in recurrent stroke using data from the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial. Patients and methods We assessed the risk of recurrent stroke in women compared to men using data from the POINT trial. Adults >18 years old were randomized within 12 hours of onset of minor ischemic stroke or transient ischemic attack (TIA), and followed for up to 90 days for ischemic stroke, our primary outcome. We used Cox proportional hazards model adjusted for demographics and stroke risk factors to evaluate the association between sex and stroke recurrence. We used interaction term testing and prespecified subgroup analyses to determine if the association between sex and recurrent stroke differed by age (<60 versus >60 years old), locale (US versus non-US), and index event type (stroke versus TIA). Last, we evaluated whether sex modified the effect of common stroke risk factors on stroke recurrence. Results Of 4,881 POINT trial participants with minor stroke or high-risk TIA, 2,195 (45%) were women. During the 90-day follow-up period, 267 ischemic strokes occurred; 121 were in women and 146 in men. The cumulative risk of recurrent ischemic stroke was not significantly different among women (5.76%; 95% CI, 4.84%–6.85%) compared to men (5.67%; 95% CI, 4.83%–6.63%). Women were not at a different risk of recurrent ischemic stroke compared to men (hazard ratio [HR], 1.02; 95% CI, 0.80–1.30) in unadjusted models or after adjusting for covariates. However, there was a significant interaction of age with sex (P=0.04). Among patients <60 years old, there was a non-significantly lower risk of recurrent stroke in women compared to men (HR 0.66; 95% CI 0.42–1.05). Last, sex did not modify the association between common stroke risk factors and recurrent stroke risk. Discussion and Conclusion Among patients with minor stroke or TIA, the risk of recurrent ischemic stroke and the impact of common stroke risk factors did not differ between men and women.

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