One-year outcomes after minor stroke or high-risk transient ischemic attack Korean multicenter stroke registry analysis

Hong Kyun Park, Beom Joon Kim, Moon Ku Han, Jong Moo Park, Kyusik Kang, Soo Joo Lee, Jae Guk Kim, Jae Kwan Cha, Dae Hyun Kim, Hyun Wook Nah, Tai Hwan Park, Sang Soon Park, Kyung Bok Lee, Jun Lee, Keun Sik Hong, Yong Jin Cho, Byung Chul Lee, Kyung Ho Yu, Mi Sun Oh, Joon Tae KimKang Ho Choi, Dong Eog Kim, Wi Sun Ryu, Jay Chol Choi, Saga Johansson, Su Jin Lee, Won Hee Lee, Ji Sung Lee, Juneyoung Lee, Hee Joon Bae

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Background and Purpose: Patients with minor ischemic stroke or transient ischemic attack are at high risk of recurrent stroke and vascular events, which are potentially disabling or fatal. This study aimed to evaluate contemporary subsequent vascular event risk after minor ischemic stroke or transient ischemic attack in Korea. Methods: Patients with minor ischemic stroke or high-risk transient ischemic attack admitted within 7 days of symptom onset were identified from a Korean multicenter stroke registry database. We estimated 3-month and 1-year event rates of the primary outcome (composite of stroke recurrence, myocardial infarction, or all-cause death), stroke recurrence, a major vascular event (composite of stroke recurrence, myocardial infarction, or vascular death), and all-cause death and explored differences in clinical characteristics and event rates according to antithrombotic strategies at discharge. Results: Of 9506 patients enrolled in this study, 93.8% underwent angiographic assessment and 72.7% underwent cardiac evaluations; 25.1% had symptomatic stenosis or occlusion of intracranial arteries. At discharge, 95.2% of patients received antithrombotics (antiplatelet polytherapy, 37.1%; anticoagulation, 15.3%) and 86.2% received statins. The 3-month cumulative event rate was 5.9% for the primary outcome, 4.3% for stroke recurrence, 4.6% for a major vascular event, and 2.0% for all-cause death. Corresponding values at 1 year were 9.3%, 6.1%, 6.7%, and 4.1%, respectively. Patients receiving nonaspirin antithrombotic strategies or no antithrombotic agent had higher baseline risk profiles and at least 1.5× higher event rates for clinical event outcomes than those with aspirin monotherapy. Conclusions: Contemporary secondary stroke prevention strategies based on thorough diagnostic evaluation may contribute to the low subsequent vascular event rates observed in real-world clinical practice in Korea.

Original languageEnglish
Pages (from-to)2991-2998
Number of pages8
JournalStroke
Volume48
Issue number11
DOIs
Publication statusPublished - 2017 Nov

Keywords

  • Cerebral infarction
  • Secondary prevention
  • Stroke
  • Transient ischemic attack

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

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