Risk of Recurrent Stroke and Death After First Stroke in Long-Distance Ski Race Participants

Area of Science:

• Cardiology
• Neurology
• Public Health

Background:

• Physical activity benefits cardiovascular health but may increase atrial fibrillation risk.
• Investigating stroke outcomes in physically active individuals is crucial.

Purpose of the Study:

• To compare recurrent stroke and death rates in first-time stroke patients with prior high physical activity versus the general population.
• To analyze the relationship between atrial fibrillation and outcomes in this cohort.

Main Methods:

• A large cohort study (n=708,604) identified 5964 first-time stroke patients from Vasaloppet skiers and matched general population controls (1994-2010).
• Exclusion of individuals with severe diseases.
• Hazard ratios (HR) were calculated for recurrent stroke and death, adjusting for smoking and socioeconomic factors.

Main Results:

• The hazard ratio for recurrent stroke or death was 0.76 (95% CI 0.67 to 0.86) for skiers compared to nonskiers.
• The hazard ratio for death was 0.66 (95% CI 0.56 to 0.78), and for recurrent stroke was 0.82 (95% CI 0.70 to 0.96).
• After adjustments, the HR for death remained significant (0.70), while the HR for recurrent stroke was not statistically significant. Skiers with atrial fibrillation showed a trend towards lower risk.

Conclusions:

• Prior regular physical activity in stroke patients is associated with a reduced risk of death.
• The risk of recurrent stroke is similar between physically active and inactive individuals post-stroke.
• Higher atrial fibrillation incidence in active individuals did not translate to increased recurrent stroke risk.