Two-Year Survival After First-Ever Stroke in a General Population of 1.4 Million Japanese　― Shiga Stroke Registry ―

Takashima, Naoyuki; Arima, Hisatomi; Kita, Yoshikuni; Fujii, Takako; Miyamatsu, Naomi; Komori, Masaharu; Sugimoto, Yukihiko; Nagata, Satoru; Miura, Katsuyuki; Nozaki, Kazuhiko

doi:10.1253/circj.cj-18-0346

Cited by 20 publications

(33 citation statements)

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“…As a part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry is one of the largest ongoing populatio-nbased registry study of stroke in Japan. We previously reported the incidence rate [ 5 ] and both acute and 2-year survival rates [ 10 ] of stroke, using data from this study. We aimed to investigate the current cumulative and relative 5-year survival rates after non-fatal first-ever stroke, using a large-scale comprehensive population-based stroke registry in Shiga Prefecture, Japan.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Survival after Stroke in 1.4 Million Japanese Population: Shiga Stroke and Heart Attack Registry

et al. 2020

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Background and Purpose Although numerous measures for stroke exist, stroke remains one of the leading causes of death in Japan. In this study, we aimed to determine the long-term survival rate after first-ever stroke using data from a large-scale population-based stroke registry study in Japan.Methods Part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry is an ongoing population-based registry study of stroke, which covers approximately 1.4 million residents of Shiga Prefecture in Japan. A total 1,880 patients with non-fatal first-ever stroke (among 29-day survivors after stroke onset) registered in 2011 were followed up until December 2016. Five-year cumulative survival rates were estimated using the Kaplan-Meier method, according to subtype of the index stroke. Cox proportional hazards models were used to assess predictors of subsequent all-cause death.Results During an average 4.3-year follow-up period, 677 patients died. The 5-year cumulative survival rate after non-fatal first-ever stroke was 65.9%. Heterogeneity was present in 5-year cumulative survival according to stroke subtype: lacunar infarction, 75.1%; large-artery infarction, 61.5%; cardioembolic infarction, 44.9%; intracerebral hemorrhage, 69.1%; and subarachnoid hemorrhage, 77.9%. Age, male sex, Japan Coma Scale score on admission, and modified Rankin Scale score before stroke onset were associated with increased mortality during the chronic phase of ischemic and hemorrhagic stroke.Conclusions In this study conducted in a real-world setting of Japan, the 5-year survival rate after non-fatal first-ever stroke remained low, particularly among patients with cardioembolic infarction and large-artery infarction in the present population-based stroke registry.

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Section: Introductionmentioning

confidence: 99%

Long-Term Survival after Stroke in 1.4 Million Japanese Population: Shiga Stroke and Heart Attack Registry

et al. 2020

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“…Следует отметить, что возрастные и гендерные особенности постинсультных пациентов в регистре РЕГИОН-ЛД близки к таковым в недавно проведенном регистре инсульта в Швеции [14]. В то же время только у 6,9% пациентов вышеупомянутого регистра референсное ОНМК было повторным, тогда как в РЕГИОНЕ-ЛД таковых было 16,6%, что сопоставимо с данными исследования, проведенного в Японии (14,7%) [15], и несколько меньше, чем в других отечественных и зарубежных регистрах инсульта (22-25%) [16][17][18][19]. Доля пациентов мужского пола в регистре РЕГАТА (51,4%) была сопоставима с данным регистров ЛИС-1 (54,5%) и ЛИС-3 (55,4%) [20] [22].…”

Section: Discussionunclassified

Comparative Characteristics of Patients with Cerebral Stroke and Myocardial Infarction in Outpatient Practice: Structure of Comorbidity, Risk Factors, Drug Treatment and Outcomes

Vorobyev

Переверзева

Loukianov³

et al. 2020

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To conduct a comparative analysis of clinical and anamnestic characteristics, risk factors, pharmacotherapy and outcomes in patients with previous stroke and myocardial infarction (MI) in outpatient practice based on data from prospective outpatient registries.Material and methods. On the basis of three outpatient clinics in Ryazan, based on the results of treatment in 2012-2013, an outpatient registry of patients who had stroke of any remoteness (REGION-AR) and an outpatient registry of patients who had previous myocardial infarction (REGATA) were created, which included, respectively, 511 patients (212 men, 41.5%) and 481 patients (247 men, 51.4%). Clinical and anamnestic characteristics, risk factors, prescribed pharmacotherapy, and its compliance with clinical guidelines were evaluated.Results. Most of the patients in the REGION-AR and REGATA registries were diagnosed with arterial hypertension (AH; 97.1% and 98.5%), coronary heart disease (СHD; 75.1% and 100%), chronic heart failure (CHF; 74.0% and 94.8%), and the proportion of atrial fibrillation (AF) cases were 20.9% and 23.3%, respectively. The share of smokers was significantly higher (23.4% vs 8.9%; p<0.0001) in the REGATA registry, and the share of people with high blood pressure at the inclusion visit (82.6% vs 67.6 %; p<0.0001) and hypercholesterolemia (63.8% vs 45.8%; p<0.0001) was higher in the REGION-AR registry. In both registries, there was a generally insufficient frequency of proper medication prescriptions, while patients in the REGION registry were statistically significantly less likely to receive mandatory prescriptions in general (44.4% vs 58.2%, p<0.0001), including antihypertensive therapy for hypertension, as well as angiotensin-converting-enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs) in CHF, beta-blockers in CHF and MI history, statins in CHD, antiplatelet agents in CHD without AF. Over 3 years of follow-up, the degree of compliance of drug prescriptions with clinical recommendations increased both in the REGION-AR registry (from 44.4% to 58.2%) and in the REGATA registry (from 58.2% to 62.9%). For 36 months of prospective observation in the REGION-AR registry, as compared to the REGATA registry, there was a higher mortality rate (22.1% vs 17.0%; p=0.04), moreover the mortality rate among men was higher (22.2% vs 14.2%; p=0.03), and among women it did not differ significantly (22.1% and 20.0%; p=0.56).Conclusion. Outpatient registries of patients who survived after acute cerebrovascular accident and myocardial infarction were comparable in terms of the average age of patients, however, women prevailed in the REGION-AR study, and men - in the REGATA registry. In the registry of patients who had myocardial infarction, СHD, CHF, respiratory and digestive system diseases, chronic kidney disease, obesity were more often diagnosed, less often – heart defects and oncological diseases. This category of patients was more often prescribed ACE inhibitors/ARBs, beta-blockers, statins, antiplatelet agents. The proportion of compliance of prescriptions with clinical guidelines was higher in the registry of patients who underwent MI both at the stage of inclusion and during subsequent prospective observation. In both registries, an improvement in the quality of drug therapy was noted after 3 years of follow-up. Mortality from all causes over 3 years of follow-up was significantly higher in the registry of post-stroke patients compared to the registry of those with MI, and this was due to the higher mortality in men (1.6 times), but among women in the compared studies the death rate did not differ significantly.

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“…В регистрах РЕГИОН доля пациентов с ИБС составила 65,1%, что существенно больше и, возможно, обусловлено большей выраженностью сердечно-сосудистой патологии у пациентов, обращающихся за медицинской помощью. Информация о доле пациентов с анамнезом ИМ в регистре ОНМК была обнаружена нами только в исследовании, проведенном в Японии (6,1%), что существенно меньше, чем в отечественных регистрах [13].…”

Section: Discussionunclassified

“…Референсное ОНМК у больных регистра РЕГИОН было повторным в 22% случаев, что сопоставимо с данными как отечественных регистров ОНМК -22-24% [7,14], так и зарубежных регистровых исследований: 19,7%-25% [12,15], за исключением регистра в Японии (14,7%) [13]. Такое большое число пациентов с повторными ОНМК свидетельствует о необходимости улучшения качества вторичной профилактики мозгового инсульта.…”

Section: Discussionunclassified

Patients with History of Myocardial Infarction and Acute Cerebrovascular Accidentin Clinical Practice: Demographic, Clinical Characteristics, Drug Treatment and Outcomes (Data of Outpatient and Hospital Registry REGION)

Okshina

Loukianov

Martsevich

et al. 2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To assess the demographic and clinical characteristics, drug treatment and outcomes in patients with a history of acute cerebrovascular accident (ACVA) and with concomitant history of myocardial infarction (MI) in clinical practice based on outpatient and hospital parts of REGION registry.Material and methods. The total 1886 patients with a history of ACVA (aged of 70.6±12.5 years, 41.9% men) were enrolled into the outpatient registry REGION (Ryazan) and the hospital registry REGION (Moscow). 356 patients had ACVA and a history of MI (group “ACVA+MI” and 1530 patients had ACVA without history of MI (group “ACVA without MI”). The incidence of cardiovascular diseases (CVD), non-CVD comorbidities, drug therapy and outcomes were analyzed.Results. In the group ACVA+MI compared with group ACVA without MI the significantly higher proportions of patients with the following conditions (diagnosis) were revealed: arterial hypertension (AH) – 99.1% and 94.2%; coronary heart disease (CHD) – 100% and 57%; chronic heart failure (CHF) – 61.5% and 41.8%; atrial fibrillation (AF) – 42.7% and 23.8%; repeated ACVA – 32.9% and 18.9%, respectively, p<0.0001 for all. In ACVA+MI and ACVA without MI groups the respective proportions of patients were smokers – 16.2% and 23.7% (p=0.10), had a family history of premature CVD – 3.2% and 1.2% (p=0.01), and had a hypercholesterolemia – 47% and 59.7% (p<0.001). The incidence of drug administration with proved positive prognostic effect was insufficient in both groups, but higher in the ACVA+MI group compared with ACVA without MI group (on average 47.1% and 40%, respectively), including: anticoagulants in AF – 19.1% and 21.4% (p=0.55); antiplatelets in CHD without AF – 69.4% and 42% (p<0.001); statins in CHD – 26.4% and 17.2% (p<0.001); beta-blockers in CHF – 39% and 23.8% (p=0.002), respectively. During 4- year follow-up in the group ACVA+MI compared with group ACVA without MI there were significantly higher all-cause mortality – 44.9% and 26.8% (p<0.001), nonfatal recurrent ACVA – 13.7% and 5.6% (p=0.0001), and nonfatal MI – 6.9% and 1.0% (p<0.0001), respectively.Conclusion. The proportion of patients with a history of MI was 18.9% among the patients with a history of ACVA. In patients of ACVA+MI group, compared with patients of ACVA without MI group a higher incidence of the following characteristics was revealed: a presence of AH, CHD, CHF, AF, repeated ACVA and a family history of premature CVD. The incidence of taking drug with proved positive effect on prognosis in patients of the compared groups was insufficient, especially of statins and anticoagulants in AF. During the follow-up period ACVA+MI group was characterized by a higher all-cause mortality and higher incidence of nonfatal ACVA and MI. In these patients the improvement of the quality of pharmacotherapy and of the secondary prevention effectiveness are the measures of especial importance.

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Two-Year Survival After First-Ever Stroke in a General Population of 1.4 Million Japanese　― Shiga Stroke Registry ―

Cited by 20 publications

References 14 publications

Long-Term Survival after Stroke in 1.4 Million Japanese Population: Shiga Stroke and Heart Attack Registry

Long-Term Survival after Stroke in 1.4 Million Japanese Population: Shiga Stroke and Heart Attack Registry

Comparative Characteristics of Patients with Cerebral Stroke and Myocardial Infarction in Outpatient Practice: Structure of Comorbidity, Risk Factors, Drug Treatment and Outcomes

Patients with History of Myocardial Infarction and Acute Cerebrovascular Accidentin Clinical Practice: Demographic, Clinical Characteristics, Drug Treatment and Outcomes (Data of Outpatient and Hospital Registry REGION)

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Two-Year Survival After First-Ever Stroke in a General Population of 1.4 Million Japanese ― Shiga Stroke Registry ―

Cited by 20 publications

References 14 publications

Long-Term Survival after Stroke in 1.4 Million Japanese Population: Shiga Stroke and Heart Attack Registry

Long-Term Survival after Stroke in 1.4 Million Japanese Population: Shiga Stroke and Heart Attack Registry

Comparative Characteristics of Patients with Cerebral Stroke and Myocardial Infarction in Outpatient Practice: Structure of Comorbidity, Risk Factors, Drug Treatment and Outcomes

Patients with History of Myocardial Infarction and Acute Cerebrovascular Accidentin Clinical Practice: Demographic, Clinical Characteristics, Drug Treatment and Outcomes (Data of Outpatient and Hospital Registry REGION)

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Two-Year Survival After First-Ever Stroke in a General Population of 1.4 Million Japanese　― Shiga Stroke Registry ―