Stroke recurrence among 30 days survivors of ischemic stroke in a prospective community-based study

A cohort of 209 patients (105 men and 104 women), who survived 30 days after 'first ever-in-lifetime ischemic stroke' were followed for one year. Predictors of survival were examined by log-rank test and Cox proportional hazards method. Twenty-four patients had a stroke recurrence (11.4%). Thirteen of the patients with recurrent stroke (54%) died because of the sequelae of the second stroke. Stroke recurred in 16% of patients with stoke due to atherosclerosis, in 12.5% of patients with cardioembolic stroke, and in 4.4% of patients with lacunar stroke. The life table cumulative risk of death at 6 and 12 months for patients with recurrent stroke was statistically higher (22% and 57%) than patients without recurrent stroke (13% and 29% respectively). History of untreated hypertension prior to the initial stroke (RR = 1.7, 95% CI 1.2-4.1, p<0.05) was an independent predictor of recurrence. In 134 patients (64.9%) aspirin was initiated during the first month after stroke. Only 81 patients (39.8%) continued aspirin treatment for the whole year. Life table cumulative risk of mortality among the patients treated with aspirin was 8% at 6 months and 12% at 1 year compared to 19% at 6 months and 45% at 12 months for those untreated with aspirin. We conclude that the high risk of recurrent stroke in Poland could be reduced by increased use of anti-platelets therapy and anti-hypertensive therapy after ischemic stroke.