From the Departments of Public Health and Clinical Medicine (J.P., B.C., P.-G.W.), Medicine (J.P., B.C., P.-G.W.), and Statistics, Umeå School of Business and Economics (M.E.), Umeå University, Umeå, Sweden.
Stroke. 2014 Jun;45(6):1839-41. doi: 10.1161/STROKEAHA.114.005060. Epub 2014 May 1.
Previous studies have shown heterogeneous results on predictors and rates of stroke recurrence. This study set out to investigate the long-term risk and predictors of recurrent stroke in Northern Sweden 1995 to 2008.
In the population-based Monitoring Trends and Determinants of Cardiovascular Disease (MONICA) stroke incidence registry, stroke survivors of either ischemic stroke or intracerebral hemorrhage were followed for recurrent stroke or death. Cox regression was used to identify predictors of stroke recurrence.
The study comprised 6700 patients and 26 597 person-years. During follow-up, 928 (13.9%) patients had a recurrent stroke. Comparison between the first time period (1995-1998) and the last (2004-2008) showed declined risk of stroke recurrence (hazard ratio, 0.64 [95% confidence interval, 0.52-0.78]). Previous myocardial infarction was less prevalent in the most recent cohort (P<0.001). Predictors of stroke recurrence were age (hazard ratio, 1.03 [95% confidence interval, 1.02-1.04]) and diabetes mellitus (hazard ratio, 1.34 [95% confidence interval, 1.15-1.57]). After an index intracerebral hemorrhage (n=815), a major part of recurrent events were ischemic (63%), and compared with the ischemic stroke group (n=5885), a tendency toward lower risk of recurrence was observed.
Despite declining recurrence rates in this relatively young stroke population, almost one third are either dead or have experienced a second stroke in 5 years.
先前的研究表明，中风复发的预测因素和复发率存在异质性。本研究旨在调查 1995 年至 2008 年瑞典北部长期复发中风的风险和预测因素。
在基于人群的监测心血管疾病趋势和决定因素（MONICA）中风发病率登记处，缺血性中风或脑出血的中风幸存者随访复发中风或死亡。使用 Cox 回归分析识别中风复发的预测因素。
该研究纳入了 6700 名患者和 26597 人年。随访期间，928 名（13.9%）患者发生了复发性中风。与第一时间段（1995-1998 年）相比，最近时间段（2004-2008 年）的中风复发风险下降（风险比，0.64 [95%置信区间，0.52-0.78]）。最近的队列中，先前的心肌梗死发病率较低（P<0.001）。中风复发的预测因素包括年龄（风险比，1.03 [95%置信区间，1.02-1.04]）和糖尿病（风险比，1.34 [95%置信区间，1.15-1.57]）。在指数性脑出血（n=815）后，大部分复发性事件为缺血性（63%），与缺血性中风组（n=5885）相比，观察到复发风险较低的趋势。
尽管在这个相对年轻的中风人群中复发率下降，但近三分之一的患者在 5 年内要么死亡，要么经历了第二次中风。
