Recurrence and survival after first-ever stroke in the area of Bajo Aragon, Spain. A prospective cohort study

Modrego, Pedro J.; Mainar, Rosana; Turull, Laura

doi:10.1016/j.jns.2004.06.002

Cited by 52 publications

(64 citation statements)

References 30 publications

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“…Modrego et al 19 demonstrated recurrence rates of 9.5% at 1 year and 26% at 5 years after initial stroke; however, this is an example of several studies that excluded patients with a subarachnoid hemorrhage or included ischemic stroke patients only. This review found no significant differences between studies reporting the cumulative risk of stroke recurrence after ischemic stroke only at 1 year after stroke compared to those studies including hemorrhagic strokes in their analyses.…”

Section: Discussionmentioning

confidence: 94%

“…The reported differences in risk of recurrence may also be explained by differing definitions of "stroke recurrence." There was wide variation in definition of stroke recurrence used, ranging from any focal neurological deficit lasting for Ͼ24 hours occurring after an initial stroke 3,5,14,19 to an exclusion period of 28 days, only after which further strokes were considered a recurrence. 25, 26 Coull and Rothwell previously demonstrated the effect of different definitions of stroke recurrence on estimates of risk of recurrence 90 days after first stroke in the Oxford Vascular Study and Oxford Community Stroke Project cohorts.…”

Section: Discussionmentioning

confidence: 99%

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Risk and Cumulative Risk of Stroke Recurrence

Mohan

Wolfe

Rudd

et al. 2011

Stroke

551

231

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Background and Purpose-Estimates of risk of stroke recurrence are widely variable and focused on the shortterm. A systematic review and meta-analysis was conducted to estimate the pooled cumulative risk of stroke recurrence. Methods-Studies reporting cumulative risk of recurrence after first-ever stroke were identified using electronic databases and by manually searching relevant journals and conference abstracts. Overall cumulative risks of stroke recurrence at 30 days and 1, 5, and 10 years after first stroke were calculated, and analyses for heterogeneity were conducted. A Weibull model was fitted to the risk of stroke recurrence of the individual studies and pooled estimates were calculated with 95% CI. Results-Sixteen studies were identified, of which 13 studies reported cumulative risk of stroke recurrence in 9115survivors. The pooled cumulative risk was 3.1% (95% CI, 1.7-4.4) at 30 days, 11.1% (95% CI, 9.0 -13.3) at 1 year, 26.4% (95% CI, 20.1-32.8) at 5 years, and 39.2% (95% CI, 27.2-51.2) at 10 years after initial stroke. Substantial heterogeneity was found at all time points. This study also demonstrates a temporal reduction in 5-year risk of stroke recurrence from 32% to 16.2% across the studies. Conclusions-The cumulative risk of recurrence varies greatly up to 10 years. This may be explained by differences in case mix and changes in secondary prevention over time However, methodological differences are likely to play an important role and consensus on definitions would improve future comparability of estimates and characterization of groups of stroke survivors at increased risk of recurrence. (Stroke. 2011;42:1489-1494.)Key Words: frequency Ⅲ predictors Ⅲ recurrence Ⅲ stroke P atients surviving an initial stroke are known to be at significantly increased risk for further strokes compared to the general population. 1 However, studies show considerable variation in the estimation of risk of stroke recurrence in both the early years and in the long-term after first stroke. 2 For example, the cumulative risk of stroke recurrence up to 5 years after initial stroke has been reported in population-based studies as 19% in Manhattan, 29% in Rochester, 30% in Oxfordshire, and 32% in Perth. [3][4][5][6] Accurate identification of the time at which stroke survivors are at increased risk for stroke recurrence is important for modifiable risk factors to target and to help reduce the risk of recurrence occurring. The aim of this systematic review and meta-analysis is to estimate the pooled cumulative risk of stroke recurrence at time points ranging from 30 days to 10 years after first-ever stroke. Materials and Methods Search Strategy and Selection CriteriaThis review included studies from hospital-based or communitybased stroke registers reporting the risk of stroke recurrence at any time point after first-ever stroke irrespective of study design and setting or language. Ovid Medline (1950 -November 2009), EMBASE (1950 -November 2009, and the Web of Science were searched using both medical subject heading terms ...

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Risk and Cumulative Risk of Stroke Recurrence

Mohan

Wolfe

Rudd

et al. 2011

Stroke

551

231

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“…[9] Arterial hypertension is a recognized risk factor for cardiovascular and cerebrovascular disease [28]related with atherosclerosis [29][30][31][32]. It is known that optimal control of blood pressure reduces the risk [33]as well as the recurrence of ischemic stroke [34,35].…”

Section: Discussionmentioning

confidence: 99%

“…The most relevant predictors of stroke recurrence identified in epidemiological trials include advancing age [9,10,12], arterial hypertension [12,14,15], a trial fibrillation [15,16], diabetes mellitus (DM) or impaired glucose tolerance [5,10,12,17], hyperlipidemia [15] and previous transient ischemic attack [5,16,18].…”

Section: Introductionmentioning

confidence: 99%

Recurrence after a First- ever Ischemic Stroke Development of a Clinical Prediction Rule

Cámara¹,

Varona²,

dVivas³

et al. 2013

RNIJ

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“…The most significant predictors of stroke recurrence include advancing age, arterial hypertension, atrial fibrillation, diabetes mellitus (DM), hyperlipidemia, smoking, heavy alcohol consumption, and obesity [8][9][10][11][12]. Most of these risk factors are modifiable.…”

Section: Introductionmentioning

confidence: 99%