Journal article
Predictors of Stroke Recurrence in Patients with Recent Lacunar Stroke and Response to Interventions According to Risk Status: Secondary Prevention of Small Subcortical Strokes Trial
Journal of stroke and cerebrovascular diseases, v 23(4), pp 618-624
Apr 2014
PMID: 23800503
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Among participants in the Secondary Prevention of Small Subcortical Strokes randomized trial, we sought to identify patients with high versus low rates of recurrent ischemic stroke and to assess effects of aggressive blood pressure control and dual antiplatelet therapy according to risk status.
Multivariable analyses of 3020 participants with recent magnetic resonance imaging–defined lacunar strokes followed for a mean of 3.7 years with 243 recurrent ischemic strokes.
Prior symptomatic lacunar stroke or transient ischemic attack (TIA) (hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.6, 2.9), diabetes (HR 2.0, 95% CI 1.5, 2.5), black race (HR 1.7, 95% CI 1.3, 2.3), and male sex (HR 1.5, 95% CI 1.1, 1.9) were each independently predictive of recurrent ischemic stroke. Recurrent ischemic stroke occurred at a rate of 4.3% per year (95% CI 3.4, 5.5) in patients with prior symptomatic lacunar stroke or TIA (15% of the cohort), 3.1% per year (95% CI 2.6, 3.9) in those with more than 1 of the other 3 risk factors (27% of the cohort), and 1.3% per year (95% CI 1.0, 1.7) in those with 0-1 risk factors (58% of the cohort). There were no significant interactions between treatment effects and stroke risk status.
In this large, carefully followed cohort of patients with recent lacunar stroke and aggressive blood pressure management, prior symptomatic lacunar ischemia, diabetes, black race, and male sex independently predicted ischemic stroke recurrence. The effects of blood pressure targets and dual antiplatelet therapy were similar across the spectrum of independent risk factors and recurrence risk.
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Details
- Title
- Predictors of Stroke Recurrence in Patients with Recent Lacunar Stroke and Response to Interventions According to Risk Status: Secondary Prevention of Small Subcortical Strokes Trial
- Creators
- Robert G. Hart - McMaster-CarrLesly A. Pearce - Minot Public SchoolsMajid F. Bakheet - Taibah UniversityOscar R. Benavente - University of British ColumbiaRobin A. Conwit - National Institute of Neurological Disorders and StrokeLeslie A. McClure - University of Alabama at BirminghamRobert L. Talbert - The University of Texas at AustinDavid C. Anderson - University of Minnesota
- Publication Details
- Journal of stroke and cerebrovascular diseases, v 23(4), pp 618-624
- Publisher
- Elsevier
- Grant note
- U01 NS38529-04A1 / National Institute of Neurological Disorders and Stroke
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000333813700011
- Scopus ID
- 2-s2.0-84897513716
- Other Identifier
- 991019231750004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Neurosciences
- Peripheral Vascular Disease