Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2014 Dec;20(12):1029-35.
doi: 10.1111/cns.12329. Epub 2014 Oct 13.

Recurrent stroke was associated with poor quality of life in patients with transient ischemic attack or minor stroke: finding from the CHANCE trial

Yi-Long Wang  1 , Yue-Song Pan, Xing-Quan Zhao, David Wang, S Claiborne Johnston, Li-Ping Liu, Xia Meng, An-Xin Wang, Chun-Xue Wang, Yong-Jun Wang; CHANCE investigators
Affiliations
Randomized Controlled Trial

Recurrent stroke was associated with poor quality of life in patients with transient ischemic attack or minor stroke: finding from the CHANCE trial

Yi-Long Wang et al. CNS Neurosci Ther. 2014 Dec.

Abstract

Aims: To examine the health-related quality of life (HRQOL) in patients with transient ischemic attack (TIA) or minor stroke and assess the impact of recurrent stroke on HRQOL.

Methods: Health-related quality of life data on patients participated in the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial were analyzed. The available 90-day EuroQoL data (EQ-5D) were used to calculate EQ-5D index score. Poor HRQOL was defined as an EQ-5D index score ≤0.5. The characteristics of HRQOL and factors predicting poor HRQOL in these patients were then explored.

Results: Among the total 5170 patients enrolled, 90-day HRQOL data were obtained from 5104 patients for analysis. The mean EQ-5D index score at day 90 was 0.88 ± 0.21 for all patients, but only 0.42 ± 0.35 for those with recurrent strokes. Poor 90-day HRQOL was found in 294 (5.8%) patients. Patients with poor HRQOL had more strokes during follow-up than patients with good HRQOL (94.9 vs. 4.7%, P < 0.001). Age, history of hypertension and diabetes, and NIHSS at baseline were independent risk factors for predicting poor HRQOL. Stroke recurrence, NIHSS at baseline, age, and minor stroke on admission became independent risk factors once stroke recurrence was added into the model.

Conclusions: Stroke recurrence was associated with poor HRQOL in patients with TIA or minor strokes. Interventions focusing on controlling risk factors and prevention of worsening of neurological function may prevent poor HRQOL in these patients.

Keywords: EQ-5D; Health outcomes; Quality of life; Stroke; Transient ischemic attack.

PubMed Disclaimer

Conflict of interest statement

Dr. Johnston is the principal investigator of the POINT trial, a NIH‐sponsored trial with clopidogrel and placebo donated by Sanofi.

Figures

Figure 1
Figure 1
EQ‐5D domains for patients at day 90 after a transient ischemic attack or minor stroke.
Figure 2
Figure 2
Box plot of EQ‐5D index score and EQ‐VAS by mRS and NIHSS levels at day 90 after a transient ischemic attack or minor stroke. EQ‐5D, European quality of life scale; VAS, visual analog scale; mRS, modified Rankin Scale; NIHSS, National Institutes of Health stroke scale. (A): EQ‐5D index score by mRS levels at day 90. (B): EQ‐5D index score by NIHSS levels at day 90. (C): EQ‐VAS by mRS levels at day 90. (D): EQ‐VAS by NIHSS levels at day 90.
See this image and copyright information in PMC

References

    1. Christensen MC, Mayer S, Ferran JM. Quality of life after intracerebral hemorrhage: results of the Factor Seven for Acute Hemorrhagic Stroke (FAST) trial. Stroke 2009;40:1677–1682. - PubMed
    1. Ali M, Fulton R, Quinn T, Brady M; VISTA Collaboration . How well do standard stroke outcome measures reflect quality of life? A retrospective analysis of clinical trial data. Stroke 2013;44:3161–3165. - PubMed
    1. Alli O, Doshi S, Kar S, et al. Quality of life assessment in the randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) trial of patients at risk for stroke with nonvalvular atrial fibrillation. J Am Coll Cardiol 2013;61:1790–1798. - PubMed
    1. Sprigg N, Selby J, Fox L, Berge E, Whynes D, Bath PM. Very low quality of life after acute stroke: data from the Efficacy of Nitric Oxide in Stroke trial. Stroke 2013;44:3458–3462. - PubMed
    1. Sturm JW, Donnan GA, Dewey HM, et al. Quality of life after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2004;35:2340–2345. - PubMed

Publication types