Recurrence and predictive factors after ischemic stroke

Objective To investigate the recurrence rate and predictors for stroke recurrence within 2 years.Methods In this study,860 patients with first-ever ischemic stroke from May 2005 to May 2008 were enrolled and registered in Nanjing stroke registry program.All the patients were classified by TOAST criteria and followed-up for two years since its first episode.According to whether the recurrent stroke occurred,all the patients were divided into recurrent group(106 cases) and non-recurrent group(754 cases).261 patients were suffering from large artery atherosele- rosis(LAA).186 patients were suffering from small artery occlusion(SAO).191 patients were suffering from cardioembolism(CES),and 222 patients were suffering from other determined or undetermined types(UND).To analyse the difference of recurrence rate according to the TOAST stroke criterion,risk factors were calculated by logistic regression analysis.Results Pairwise comparison found that CES had the highest recurrence rate.In the recurrent group,age,hypertension, diabetes,smoking,and fibrinogen levels were significantly higher than those without recurrent stroke(P0.05,P0.01);compliance of anti-platelet drugs was significantly lower than that without recurrent stroke(P0.01).106 patients suffered from recurrent stroke,among which there were 29 LAA,22 SAO,36 CES,and 19 UND.Pairwise comparison found that CES had the highest recurrence rate.Through logistic regression analysis,age,hypertension,diabetes, plasma fibrinogen,TOAST subtypes and compliance of anti-platelet drugs were associated with recurrence of ischemic stroke.Conclusion There is significantly difierent recurrence rate for varied subtypes of ischemic stroke.Plasma fibrinogen,TOAST criterion and compliance of anti-platelet drugs are the independent risk factors for recurrent stroke.