MITRAL-VALVE PROLAPSE AND THE RISK OF STROKE AFTER INITIAL CEREBRAL-ISCHEMIA

Referral-based studies suggest that patients with cerebral ischemia an d mitral valve prolapse are prone to recurrent cerebral ischemic event s. Our purpose was to determine the risk of subsequent stroke in a pop ulation-based group of patients with ischemic stroke or TIA and mitral valve prolapse. From 1975 through 1990, 49 residents of Olmsted Count y, MN, had an initial ischemic stroke or TIA and echocardiographically diagnosed mitral valve prolapse. Risk of subsequent stroke in this co hort was compared with the age- and sex-adjusted rates of recurrent st roke after initial cerebral ischemia in the Rochester, MN, population. Mean age of the patients was 72 years. Thirty-one (63%) were women. N ine had subsequent stroke (5.5 per 100 person-years). For Rochester pa tients who had initial ischemic stroke in the period 1975 through 1984 , 10.72 recurrent strokes were expected (relative risk, 0.84; 95% conf idence limits, 0.38 to 1.59). For Rochester patients with initial isch emic stroke or TIA in the period 1975 through 1979, 12.31 recurrent st rokes were expected (relative risk, 0.73; 95% confidence limits, 0.33 to 1.39). There is no evidence of increased subsequent stroke risk amo ng patients with initial episodes of cerebral ischemia and mitral valv e prolapse relative to the age- and sex-adjusted recurrent stroke rate s in the community.