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A population-based study of the incidence and prognosis of lacunar stroke
Insights
Lacunar stroke incidence was 33.0 per 100,000 annually. While short-term risks were lower than nonlacunar stroke, long-term death and recurrence risks became similar.
Area of Science:
- Neurology
- Epidemiology
Background:
- Lacunar stroke is a subtype of ischemic stroke.
- Understanding its incidence and prognosis is crucial for public health.
Purpose of the Study:
- To determine the incidence and prognosis of lacunar stroke.
- To compare lacunar stroke outcomes with nonlacunar stroke.
Main Methods:
- Prospective, population-based study.
- Inclusion of first-ever strokes from 1994-1998.
- Assessment of incidence, risk factors, mortality, and recurrence.
Main Results:
- Annual incidence of first-ever lacunar stroke was 33.0/100,000.
- Lacunar stroke patients had higher rates of smoking and hypercholesterolemia, and lower rates of atrial fibrillation.
- 30-day and 1-year case-fatality rates for lacunar stroke were 4.3% and 13.0%, respectively.
- First-year stroke recurrence was lower for lacunar stroke (2.83%) compared to nonlacunar stroke (5.10%), with similar rates thereafter.
Conclusions:
- Short-term vascular events were more frequent in nonlacunar stroke.
- Long-term risks of death and stroke recurrence were similar between lacunar and nonlacunar stroke patients.
Objective:
To evaluate incidence and prognosis of lacunar stroke in a prospective, population-based patient registry.
Methods:
The authors included first-ever strokes occurring between 1994 and 1998. They assessed incidence, risk factors, mortality, and recurrence in patients with lacunar stroke.
Results:
The authors identified 491 patients (15.3%) with lacunar stroke (252 men and 239 women) and 2,153 patients (67.3%) with nonlacunar stroke (998 men and 1,155 women). Crude annual incidence rate for a first-ever lacunar stroke was 33.0/100,000 (95% CI 30.2 to 36.0). At the univariate logistic regression analysis among patients with lacunar stroke there was a higher proportion of cigarette smoking and hypercholesterolemia and a lower proportion of chronic atrial fibrillation than in patients with nonlacunar stroke. For lacunar stroke, the 30-day case-fatality rate was 4.3% (95% CI 2.5 to 6.1) and the 1-year case-fatality rate was 13.0% (95% CI 10.0 to 16.0). During the first year of follow-up the average annual stroke recurrence rate was lower in patients with lacunar (2.83%; 95% CI 1.36 to 4.30) than in those with nonlacunar stroke (5.10%; 95% CI 4.17 to 6.03) while from the second year onward, rates were similar in both groups.
Conclusion:
In the short term, patients with nonlacunar stroke had more vascular events, but in the long term, the risk of death and of stroke recurrence was similar.
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