RISK-FACTORS FOR EARLY RECURRENCE AFTER ISCHEMIC STROKE - THE ROLE OFSTROKE SYNDROME AND SUBTYPE

Background and Purpose-Information regarding risk factors for early re currence is limited. Our aim was to identify the clinical predictors o f early recurrence after ischemic stroke, Methods-We prospectively exa mined 297 patients (mean age, 72.0+/-8.4 years) hospitalized with isch emic stroke to identify recurrent strokes occurring within 90 days of the index stroke. Survival free of recurrence was estimated using Kapl an-Meier analysis stratified by demographic variables; vascular risk f actors; stroke syndrome, subtype, vascular territory, and severity; sc ores on the Barthel Index and Mini-Mental State Examination during hos pitalization; blood pressure on admission; and selected laboratory dat a. We estimated the relative risk (RR) of early recurrence associated with those variables using proportional hazards analysis. Results-We i dentified 22 recurrent events in the first 90 days after the index str oke, resulting in an early stroke recurrence rate of 7.4%, and death o ccurred immediately after recurrence in 6 of the 22 patients, A major hemispheric stroke syndrome (RR=2.9; 95% confidence interval [CI]=1.2 to 7.1), atherothrombotic stroke mechanism (RR=3.3; CI=1.3 to 8.3), an d atrial fibrillation (RR=2.2; CI=0.8 to 6.1) were independent predict ors of early recurrence, after adjustment for demographic variables. C onclusions-Early recurrence was frequent and resulted in increased mor tality. Attention to the clinical features of the index stroke, includ ing the presenting syndrome and the ischemic mechanism, and the recogn ition of atrial fibrillation may help in the selection of patients for the initiation of targeted interventions to prevent early recurrence and subsequent mortality.