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[Primary and secondary cardiovascular prevention results in patients with stroke: relapse risk and associated
Josep Ll Clua-Espuny1, Josep Ll Piñol-Moreso, Vicente F Gil-Guillén
1Equipo de Atención Primaria Tortosa 1-est, Servicio de Atención Primaria Terres de l'Ebre, Institut Català de la Salut, Tortosa, Tarragona, España. jlclua@telefonica.net
Insights
Stroke incidence and cardiovascular risk factors control (CVRF) are crucial for preventing stroke recurrence and improving survival. Secondary prevention strategies appear more effective in managing CVRF and enhancing patient outcomes.
Area of Science:
- Neurology
- Cardiology
- Public Health
Context:
- Stroke prevalence and cardiovascular risk factors control (CVRF) significantly impact stroke incidence and recurrence.
- Effective management of CVRF is essential for reducing mortality and disability associated with stroke.
Purpose:
- To estimate the incidence of first-time stroke episodes.
- To describe the outcomes of primary and secondary cardiovascular prevention strategies.
Summary:
- An observational, prospective study followed 130,649 individuals aged 15-90. Of 553 enrolled stroke patients, hypertension, atrial fibrillation, and dyslipidemia increased post-stroke, despite improved control.
- 47% faced high relapse risk, with 15.7% experiencing recurrence (48.3% being stroke). Prior cardiovascular events and aging were key predictors.
Impact:
- Cardiovascular secondary prevention demonstrates greater effectiveness in CVRF detection and control.
- Enhanced CVRF management is critical for improving stroke survival rates and reducing long-term disability.
Introduction:
The prevalence and cardiovascular risk factors control (CVRF) are determining to suffer a stroke and its relapse which arise the mortality and disability.
Aim:
To estimate the incidence of the first episode of ictus and describe the results in primary and secondary cardiovascular prevention.
Patients And Methods:
Observational and prospective study of a fix cohort of 130,649 people, 15-90-year-old assigned to participants centers between 01/04/2006 and 31/03/2008. Community based register. Analyses were performed with the use of time-to-event methods, included Cox's multivariate on survival, risk of it's relapse; the CVRF diagnosed and it's relative risk (RR); cardiovascular risk.
Results:
553 patients were enrolled (48,8% female), average age 73.3 ± 11.6 years with the first episode of stroke. After the episode, the hypertension (74.9% vs 88.7%), atrial fibrillation (9.9% vs 16%) and dislipemia (37.8% vs 49.8%) increased significantly as well its control. The 47% (95% CI = 42.8-51.2) of the cases had high risk of relapsing. In the 15.7% of the patients happened relapse of cardiovascular event, 48.3% of which were stroke. The main predictors variables were history of recurrent cardiovascular event (RR = 6.7; 95% CI = 2.2-21.7) and the aging (RR = 1,08; 95% CI = 1.01-1.2).
Conclusion:
The cardiovascular secondary prevention seems to be more effective both in CVRF's detection and its control and is extremely important to get better results of survival.
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