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Cited by 336

The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.

Risk and Secondary Prevention of Stroke Recurrence: A Population-Base Cohort Study

Open access
Flach, Clare, Muruet, Walter, Wolfe, Charles D.A., Bhalla, Ajay, Douiri, Abdel·2020·Stroke
DOI 10.1161/strokeaha.120.028992
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Abstract

Background and Purpose: With recent advances in secondary prevention management, stroke recurrence rates may have changed substantially. We aim to estimate risks and trends of stroke recurrence over the past 2 decades in a population-based cohort of patients with stroke. Methods: Patients with a first-ever stroke between 1995 and 2018 in South London, United Kingdom (n=6052) were collected and analyzed. Rates of recurrent stroke with 95% CIs were stratified by 5-year period of index stroke and etiologic TOAST (Trial of ORG 10172 in Acute Stroke Treatment) subtype. Cumulative incidences were estimated and multivariate Cox models applied to examine associations of recurrence and recurrence-free survival. Results: The rate of stroke recurrence at 5 years reduced from 18% (95% CI, 15%–21%) in those who had their stroke in 1995 to 1999 to 12% (10%–15%) in 2000 to 2005, and no improvement since. Recurrence-free survival has improved (35%, 1995–1999; 67%, 2010–2015). Risk of recurrence or death is lowest for small-vessel occlusion strokes and other ischemic causes (36% and 27% at 5 years, respectively). For cardioembolic and hemorrhagic index strokes around half of first recurrences are of the same type (54% and 51%, respectively). Over the whole study period a 54% increased risk of recurrence was observed among those who had atrial fibrillation before the index stroke (hazard ratio, 1.54 [1.09–2.17]). Conclusions: The rate of recurrence reduced until mid-2000s but has not changed over the last decade. The majority of cardioembolic or hemorrhagic strokes that have a recurrence are stroke of the same type indicating that the implementation of effective preventive strategies is still suboptimal in these stroke subtypes.

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Metadata

Authors
Flach, C., Muruet, W., Wolfe, C. D. A., Bhalla, A., & Douiri, A.
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-08
Volume
51
Issue
8
Pages
2435-2444
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/strokeaha.120.028992
OpenAlex
W3042131576
Cited by
336
References
29
FWCI
19.97
Type
journal article
Language
en
Open access
hybrid

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