Impacts of treatments on recurrence and 28-year survival of ischemic stroke patients

Abstract

Aspirin and nicametate are well-established therapies for preventing recurrence and mortality from stroke in patients diagnosed as ischemic stroke. However, their respective effects on the recurrence, making allowance for the duration of recurrence and death without the occurrence of recurrence, and long-term survival have not been well elucidated. We aimed to evaluate long-term effect of two kinds of treatment on cerebrovascular death among ischemic stroke patients with or without the recurrence of stroke. Data used in this study were derived from the cohort based on a multicenter randomized double-blind controlled trial during 1992 to 1995 with the enrollment of a total of 466 patients with first-time non-cardioembolic ischemic stroke who were randomly allocated to receive aspirin (n = 222) or nicametate (n = 244). The trial cohort was followed up over time to ascertain the date of recurrence within trial period and death until Sep of 2019. The time-dependent Cox regression model was used to estimate the long-term effects of two treatments on death from cerebrovascular disease with and without recurrence. A total of 49 patients experienced stroke recurrence and 89 cerebrovascular deaths was confirmed. Patients treated with nicametate were more likely, but non statistically significantly, to have recurrence (aHR: 1.73, 95% CI 0.96–3.13) as compared with those treated by aspirin. Nicametate reduced the risk of cerebrovascular death about 37% (aHR: 0.63, 95% CI 0.41–0.97) compared with aspirin. The aspirin group had a lower recurrence rate than the nicametate group even with recurrence after 1–2 years of follow-up of first stroke but the latter had significantly reduced death from cerebrovascular disease for nicametate group, which requires more research to verify.

One-year recurrence of stroke and death in Lebanese survivors of first-ever stroke: Time-to-Event analysis

“…However, recurrence of stroke was responsible for 56% of these deaths in our study, 41% in the 3 months, 9% during the 3 to 6 months, and 6% at 12 months post first-ever stroke, where the possible reason is older age (72% were ≥80 years old). Similar to other results (79,(85)(86)(87)(88), stroke recurrence increases the risk of death four times among stroke survivors.…”

Thirty-six months recurrence after acute ischemic stroke among patients with comorbid type 2 diabetes: A nested case-control study

“…Stroke patients face a high likelihood of recurrence after the initial onset of IS, ranging from 5.4% at 1 year to 11.3% at 5 years (Khanevski et al, 2019). Patients with stroke recurrence have a higher likelihood to endure more serious brain damage and neurologic dysfunction, leading to a worse functional status and/or higher case fatality rate vs. initial stroke Wang et al, 2021). Physical activity, antihypertensive treatment, and high fiber intake (i.e., fruits and vegetables) have preventive effects on IS recurrence (Gillman et al, 1995;Zonneveld et al, 2018;.…”