Department of Public Health, Shiga University of Medical Science.
Department of Public Health, Kindai University Faculty of Medicine.
Circ J. 2020 May 25;84(6):943-948. doi: 10.1253/circj.CJ-20-0024. Epub 2020 Apr 29.
Despite many effective strategies for the prevention of recurrent stroke, individuals who survive an initial stroke have been shown to be at high risk of recurrent stroke. The aim of this study was to investigate the current status of stroke recurrence after first-ever stroke using a population-based stroke registry in Japan.
As part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry is an ongoing population-based stroke registry study that covers approximately 1.4 million residents of Shiga Prefecture, Japan. A total of 1,883 first-ever stroke survivors at 28 days was registered in 2011 and followed-up until the end of 2013. Recurrence was defined as any type of stroke after 28 days from the onset of an index event. Two-year cumulative recurrence rates were estimated using cumulative incidence function methods. Over a mean 2.1-year follow-up period, 120 patients experienced recurrent stroke and 389 patients died without recurrence. The 2-year cumulative recurrence rate was higher in patients with index ischemic stroke (6.8%) than in those with index hemorrhagic stroke (3.8%).
Two-year cumulative recurrence rate after first-ever stroke remained high, particularly among patients with ischemic stroke, in the present population-based registry study in a real-world setting in Japan. Further intensive secondary prevention strategies are required for these high-risk individuals.
尽管有许多预防复发性中风的有效策略，但首次中风幸存的个体仍存在较高的中风复发风险。本研究旨在使用日本基于人群的中风登记处调查首次中风后的中风复发现状。
作为滋贺中风和心脏病发作登记处的一部分，滋贺中风登记处是一项正在进行的基于人群的中风登记研究，覆盖了日本滋贺县约 140 万居民。2011 年共登记了 1883 例 28 天内的首次中风幸存者，并随访至 2013 年底。复发定义为指数事件发生后 28 天内的任何类型中风。使用累积发生率函数方法估计 2 年累积复发率。在平均 2.1 年的随访期间，120 名患者经历了中风复发，389 名患者无复发死亡。索引缺血性中风患者（6.8%）的 2 年累积复发率高于索引出血性中风患者（3.8%）。
在日本的真实环境下，本次基于人群的登记研究中，首次中风后的 2 年累积复发率仍然较高，特别是在缺血性中风患者中。需要为这些高风险个体制定更强化的二级预防策略。
