Recurrence Risk after Noncardioembolic Mild Ischemic Stroke in a Japanese Population

• Published in: Cerebrovascular diseases (Basel, Switzerland) Vol. 31; no. 4; pp. 365 - 372
• Main Authors: Kono, Yuji, Yamada, Sumio, Kamisaka, Kenta, Araki, Amane, Fujioka, Yusuke, Yasui, Keizo, Hasegawa, Yasuhiro, Koike, Yasuo
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2011
• Subjects: Asian Continental Ancestry Group - statistics & numerical data; Brain Ischemia - diagnosis; Brain Ischemia - ethnology; Brain Ischemia - mortality; Brain Ischemia - physiopathology; Chi-Square Distribution; Disability Evaluation; Female; Humans; Japan - epidemiology; Kaplan-Meier Estimate; Life Style; Magnetic Resonance Imaging; Male; Middle Aged; Original Paper; Proportional Hazards Models; Recurrence; Risk Assessment; Risk Factors; Severity of Illness Index; Stroke - diagnosis; Stroke - ethnology; Stroke - mortality; Stroke - physiopathology; Time Factors; Japan; Lifestyle; Pathophysiology; Recurrence risk factor; Mild stroke
• ISSN: 1015-9770; 1421-9786
• DOI: 10.1159/000323233

Background and Purpose: This study aimed to identify the recurrence rate and risk factors or clinical variables predictive of vascular events after mild ischemic stroke (IS). Methods: From December 2006 to September 2007, patients with acute IS with a modified Rankin Scale of 0∼1 were consecutively enrolled in this study. Variables including sex, family history of vascular disease, age, height, weight, stroke subtype, blood pressure, lipid profile, fasting glucose, HbA1c, smoking, alcohol consumption, exercise habits, waist circumference, ankle-brachial pressure index, salt intake and physical activity were assessed. The primary outcome was stroke recurrence or other vascular events such as myocardial infarction, angina pectoris, and peripheral artery disease. Survival curves were calculated by Kaplan-Meier survival analysis, and hazard ratios for recurrence were determined by univariate and multivariate Cox proportional hazards regression models. Results: A total of 102 mild IS patients (78 men and 24 women, mean age 64 years) were successfully followed for 3 years. Of those 102 patients, 25 (24.5%) had stroke recurrence, and 4 (3.9%) had a coronary event. Among the variables studied, abnormal ankle-brachial pressure index, metabolic syndrome, stroke subtypes, salt intake and poor lifestyle management were significant independent predictors of stroke recurrence or cardiovascular events. Conclusions: In mild IS patients within 3 years after onset, not only pathophysiological factors but also lifestyle factors can aid in the identification of patients at high risk for recurrence.