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Recurrent stroke and cardiac risks after first ischemic stroke: the Northern Manhattan Study.
M S Dhamoon1, R R Sciacca, T Rundek
1Mount Sinai School of Medicine, New York, NY, USA.
Neurology
|March 15, 2006
Summary
After a first ischemic stroke, the risk of recurrent stroke is twice that of cardiac events over 5 years. This highlights the need for therapies targeting both stroke and cardiac event prevention.
Area of Science:
- Neurology
- Cardiology
- Epidemiology
Background:
- Long-term follow-up studies comparing recurrent stroke and cardiac event risks after initial ischemic stroke are limited.
- Understanding the relative risks is crucial for guiding treatment decisions in stroke survivors.
Purpose of the Study:
- To compare the long-term risk of recurrent stroke versus cardiac events following a first ischemic stroke.
- To inform clinical practice regarding secondary prevention strategies.
Main Methods:
- Prospective follow-up of 655 ischemic stroke patients (age ≥ 40) from the Northern Manhattan Study.
- Kaplan-Meier survival analysis and Cox proportional hazard models were used to calculate event risks.
- Outcomes included recurrent stroke, myocardial infarction (MI), and cause-specific mortality.
Main Results:
- The 5-year risk of recurrent stroke (18.3%) was more than double the risk of cardiac events (8.6%).
- Nonfatal recurrent stroke risk (14.8%) was twice that of fatal cardiac events (6.4%).
- Cardiac mortality risk was nearly double that of fatal stroke.
Conclusions:
- Long-term risk of any stroke (fatal or nonfatal) is approximately double the risk of any cardiac event after a first ischemic stroke.
- The substantial risk of nonfatal recurrent stroke underscores the importance of aggressive secondary prevention therapies.