Long-term risk of recurrent stroke high in stroke, TIA survivors with no early complications
Survivors of stroke or transient ischaemic attack (TIA) with no early complications suffer from higher long-term risks of recurrent stroke and admission into an institution, a new study has found.
The study included 26,366 stroke or TIA patients (median age 72 years; 46.9 percent female) who survived for 90 days without complications. Controls (n=263,660; mean age 72 years; 46.9 percent female) were matched for geographic location, sex and age. Rates of composite and individual outcomes of death, stroke, myocardial infarction (MI) or admission to continuing care were calculated at 1, 3 and 5 years.
At 1 year, 9.5 percent of the patients who were event-free at 90 days after stroke or TIA experienced the primary composite outcome. The 3- and 5-year composite outcome rates were 23.6 and 35.7 percent, respectively. Rates were higher than in the corresponding controls (5.4, 13.6 and 21.1 percent, respectively).
Five-year rates of the secondary outcomes of stroke (7.8 vs 1.6 percent), MI (3.9 vs 2.5 percent), admission to continuing care (8.9 vs 4.7 percent) and death (26.0 vs 16.9 percent) were all higher in cases than in controls.
The risk for the primary outcome in cases was more than twice than in controls at 1 year (hazard ratio [HR], 2.4; 95 percent CI, 2.3 to 2.5). This was consistent at 3 (HR, 2.2; 2.1 to 2.3) and 5 (HR, 2.1; 2.1 to 2.2) years.
Long-term risk of recurrent stroke in cases at 1 (HR, 6.8;6.1 to 7.5), 3 (HR, 5.6; 5.2 to 6.0) and 5 (HR, 5.1; 4.8 to 5.5) years was the highest among all outcomes examined.