Related Experiment Video
Updated: Sep 20, 2025
Author Spotlight: Advancing Stroke Research with Periorbital Doppler Monitoring of Regional Cerebral Blood Flow in Rodent Models
Published on: November 22, 2024
Major cardiovascular events and all-cause mortality after ischemic stroke in central Norway - A three-year
Ailan Phan1, Bent Indredavik2, Stian Lydersen3
1Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway.
Insights
Long-term stroke outcomes show a 15% incidence of major cardiovascular events and 18% mortality within three years. Reducing cardiac disease risk and stroke severity can improve survival for stroke patients.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Public Health
Background:
- Cardiovascular disease incidence has declined due to improved prevention and risk factor management.
- Updated long-term outcome data for first-ever ischemic stroke survivors are limited.
Purpose of the Study:
- To assess major cardiovascular events and all-cause mortality three years after a first-ever ischemic stroke.
- To evaluate the impact of modifiable cardiovascular and other prognostic factors on stroke outcomes.
Main Methods:
- The MIDNOR STROKE study prospectively enrolled 787 patients with first-ever ischemic stroke in Central Norway (2015-2017).
- Data collected during hospitalization were linked with national registries for three-year follow-up on major cardiovascular events and survival.
- Competing risk models, Kaplan-Meier, and Cox regression analyzed cardiovascular events and all-cause mortality.
Main Results:
- The cumulative incidence of major cardiovascular events within three years was 15.0%, with recurrent stroke being most frequent.
- All-cause mortality rate was 18.0% at three years post-stroke.
- Coronary artery disease increased the risk of major vascular events (HR: 1.59) and death (HR: 1.66); NIHSS at day 1 predicted mortality (HR: 1.08).
Conclusions:
- Three-year survival post-stroke is higher than previously reported, but the risk of major cardiovascular events remains significant.
- Approximately 15% of stroke survivors experience major cardiovascular events within three years.
- Interventions targeting cardiac disease risk reduction and minimizing stroke severity are crucial for improving long-term stroke outcomes.
Background:
A substantial decline in the incidence of stroke and ischemic heart disease during the last decade is probably due to improved preventive treatment and a reduction in cardiovascular risk factors. Updated estimates on long-term outcomes following first-ever ischemic stroke are therefore limited.
Purpose:
To assess the incidence of major cardiovascular events and all-cause mortality three years post-stroke, and to evaluate the impact of modifiable cardiovascular and other prognostic factors.
Methods:
MIDNOR STROKE is a multicenter prospective study including patients with first-ever ischemic stroke admitted to stroke units in Central Norway during 2015-2017. Data were collected during the hospital stay. Information on major cardiovascular events and survival three years post-stroke was retrieved from national medical registries. Competing risk models were used to analyze cardiovascular events. All-cause mortality was analyzed by using Kaplan-Meier and Cox regression.
Results:
Among 787 included participants, the cumulative incidence of major cardiovascular events was 15.0 % (95 % CI: 12.0-17.0 %), with recurrent stroke as the most common event. The all-cause mortality rate was 18.0 % (95 % CI: 15.0-20.0 %). Coronary artery disease was associated with a higher risk of major vascular events HR: 1.59, 95 % CI: 1.06, 2.38) and all-cause death (HR: 1.66, 95 % CI: 1,11, 2.50). NIHSS at day 1 predicted all-cause mortality (HR: 1.08, 95 % CI: 1.05, 1.10).
Conclusion:
Three-year survival rates post-stroke were higher compared to previous reports; however, the risk of major cardiovascular events remains substantial, affecting 15 % of stroke survivors within three years. Reducing cardiac disease risk and interventions aimed at minimizing stroke severity may improve long-term stroke outcomes.
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...