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Comprehensive Prestroke Risk Factor Control and Functional Outcomes After Acute Ischemic Stroke
Joon-Tae Kim1, Ji Sung Lee2, Hyunsoo Kim1
1Department of Neurology Chonnam National University Hospital, Chonnam National University Medical School Gwangju Korea.
Journal of the American Heart Association
|June 15, 2026
Summary
Effective management of prestroke risk factors (RFs) is linked to better functional recovery after ischemic stroke. Comprehensive control of hypertension, diabetes, dyslipidemia, and atrial fibrillation improves 3-month outcomes, regardless of RF count.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- The association between comprehensive prestroke risk factor (RF) management and 3-month functional outcomes after ischemic stroke is not well-established.
- Major RFs for ischemic stroke include hypertension, diabetes, dyslipidemia, and atrial fibrillation.
Purpose of the Study:
- To investigate if comprehensive prestroke RF management is associated with improved 3-month functional outcomes after ischemic stroke.
- To evaluate the impact of RF control levels (well, partially, poorly controlled) on functional independence post-stroke.
Main Methods:
- Analysis of ischemic stroke patients from the CRCS-K-NIH registry (2011-2022).
- Categorization of prestroke RF management as well controlled, partially controlled, or poorly controlled based on treatment and biomarker criteria.
- Primary outcome: 3-month modified Rankin Scale score of 0-2 (functional independence).
Main Results:
- Among 63,570 patients with at least one RF, 35.8% were well controlled, 35.6% partially controlled, and 28.6% poorly controlled.
- Good 3-month outcomes were observed in 66.0% (1 RF), 60.8% (2 RFs), and 55.0% (≥3 RFs).
- Both well-controlled (aOR 1.22) and partially controlled (aOR 1.14) groups showed significantly higher odds of good 3-month outcomes compared to the poorly controlled group, irrespective of RF burden.
Conclusions:
- Comprehensive prestroke RF management, defined by specific criteria, is independently associated with better 3-month functional outcomes.
- Effective prestroke management of RFs may enhance poststroke functional recovery, irrespective of the number of RFs present.
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