D. Ryglewicz et al., STROKE RECURRENCE AMONG 30 DAYS SURVIVORS OF ISCHEMIC STROKE IN A PROSPECTIVE COMMUNITY-BASED STUDY, Neurological research, 19(4), 1997, pp. 377-379
A cohort of 209 patients (105 men and 104 women), who survived 30 days
after 'first ever-in-lifetime ischemic stroke' were followed for one
year. Predictors of survival were examined by log-rank test and Cox pr
oportional hazards method. Twenty-four patients had a stroke recurrenc
e (11.4%). Thirteen of the patients with recurrent stroke (54%) died b
ecause of the sequelae of the second stroke. Stroke recurred in 16% of
patients with stoke due to atherosclerosis, in 12.5% of patients with
cardioembolic stroke, and in 4.4% of patients with lacunar stroke. Th
e life table cumulative risk of death at 6 and 12 months for patients
with recurrent stroke was statistically higher (22% and 57%) than pati
ents without recurrent stroke (13% and 29% respectively). History of u
ntreated hypertension prior to the initial stroke (RR = 1.7, 95% CI 1.
2-4.1, p<0.05) was an independent predictor of recurrence. In 134 pati
ents (64.9%) aspirin was initiated during the first month after stroke
. Only 81 patients (39.8%) continued aspirin treatment for the whole y
ear. Life table cumulative risk of mortality among the patients treate
d with aspirin was 8% at 6 months and 12% at 1 year compared to 19% at
6 months and 45% at 12 months for those untreated with aspirin. We co
nclude that the high risk of recurrent stroke in Poland could be reduc
ed by increased use of anti-platelets therapy and anti-hypertensive th
erapy after ischemic stroke.