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
. 2019 Dec 18;9(12):e032087.
doi: 10.1136/bmjopen-2019-032087.

Time to recurrence after first-ever ischaemic stroke within 3 years and its risk factors in Chinese population: a prospective cohort study

Jing Zhang  1 , Ping Zhu  1   2 , Bingqing Liu  1 , Qiang Yao  1 , Ke Yan  1 , Qianwen Zheng  1 , Yawen Li  1 , Lu Zhang  1 , Mier Li  1 , Ju Wang  1 , Cairong Zhu  3 , Muke Zhou  4
Affiliations

Time to recurrence after first-ever ischaemic stroke within 3 years and its risk factors in Chinese population: a prospective cohort study

Jing Zhang et al. BMJ Open. .

Abstract

Objective: This study aimed to estimate the time of recurrent ischaemic stroke events among the first 3 years of follow-up after hospitalisation discharge.

Study design: A prospective cohort study.

Setting: The research was conducted in the Department of Neurology at a tertiary hospital, Chengdu of China, from January 2010 to June 2016.

Outcome measures: We estimated the restricted mean survival time (RMST) of ischaemic stroke recurrence for the first 3 years after discharge. Basic sociodemographic characteristics and major potential risk factors for recurrence were collected using a semistructured questionnaire. Regression analysis of RMST was used to identify risk factors of recurrent stroke.

Participants: Patients hospitalised with first-ever ischaemic stroke were eligible for this study. Patients with severe cognitive impairment were excluded.

Results: We included 641 surviving patients who were followed up for 3 years. Stroke recurrence occurred in 115 patients, including 16 patients who died of stroke recurrence. The cumulative risk of stroke recurrence rate was 11.51% (9.20%-14.35%) at 1 year, 16.76% (13.96%-20.05%) at 2 years and 20.07% (17.00%-23.61%) at 3 years. Modified Rankin Scale (mRS) score ≥3 thus resulted in the recurrence time loss, which was 0.22 months (p=0.008) at 6 months, 0.61 months (p=0.004) at 1 year, 1.49 months (p=0.007) at 2 years and 2.46 months (p=0.008) at 3 years. It is similar with the effects of drug adherence after stroke. The recurrence time of patients ≥75 years at 3 years was 2.02 months (p=0.220) less than that of those aged <55 years.

Conclusion: In China, the time of first recurrence varies among different patients with ischaemic stroke. The mRS and the level of drug adherence after stroke are important risk factors of stroke recurrence.

Keywords: epidemiology; public health; stroke medicine.

PubMed Disclaimer

Conflict of interest statement

Competing interests: There are no financial or other interests to declare, and all authors agree to the publication of the manuscript.

Figures

Figure 1
Figure 1
Flow chart of the recruitment.
Figure 2
Figure 2
(A–C) Cumulative risk of stroke recurrence. mRS, Modified Rankin Scale.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lozano R, Naghavi M, Foreman K, et al. . Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012;380:2095–128. 10.1016/S0140-6736(12)61728-0 - DOI - PMC - PubMed
    1. Murray CJL, Vos T, Lozano R, et al. . Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012;380:2197–223. 10.1016/S0140-6736(12)61689-4 - DOI - PubMed
    1. Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. . Global and regional burden of stroke during 1990–2010: findings from the global burden of disease study 2010. The Lancet 2014;383:245–55. 10.1016/S0140-6736(13)61953-4 - DOI - PMC - PubMed
    1. Lee M, Wu Y-L, Ovbiagele B. Trends in incident and recurrent rates of first-ever ischemic stroke in Taiwan between 2000 and 2011. J Stroke 2016;18:60–5. 10.5853/jos.2015.01326 - DOI - PMC - PubMed
    1. Go AS, Mozaffarian D, Roger VL, et al. . Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation 2014;129:e28–92. 10.1161/01.cir.0000441139.02102.80 - DOI - PMC - PubMed

Publication types