Prediction factors of recurrent ischemic events in one year after minor stroke

PLoS One. 2015 Mar 16;10(3):e0120105. doi: 10.1371/journal.pone.0120105. eCollection 2015.

Abstract

Background: The risk of a subsequent stroke following a minor stroke is high. However, there are no effective rating scales to predict recurrent stroke following a minor one. Therefore, we assessed the risk factors associated with recurrent ischemic stroke or transient ischemic attack (TIA) within one year of minor stroke onset in order to identify possible risk factors.

Methods: Eight hundred and sixty-three non-cardioembolic ischemic stroke patients in the Chinese IntraCranial AtheroSclerosis Study that presented with minor stroke, defined as an admission National Institutes of Health stroke scale (NIHSS) score of ≤3, were consecutively enrolled in our study. Clinical information and imaging features upon admission, and any recurrent ischemic stroke or TIA within one year was recorded. Cox regression was used to identify risk factors associated with recurrent ischemic stroke or TIA within the year following stroke onset.

Results: A total of 50 patients (6.1%) experienced recurrent ischemic stroke or TIA within one year of minor stroke onset. Multivariate Cox regression model identified lower admission NIHSS score (HR, 1.75; 95% CI, 1.32 to 2.33; P<0.0001), history of coronary heart disease (HR, 2.62; 95% CI, 1.17 to 5.86; P = 0.02), severe stenosis or occlusion of large cerebral artery (HR, 4.68; 95% CI, 1.87 to 11.7; P = 0.001), and multiple acute cerebral infarcts (HR, 2.61; 95% CI, 1.01 to 6.80; P = 0.05) as independent risk factors for recurrent ischemic stroke or TIA within one year.

Conclusions: Some minor stroke patients are at higher risk for recurrent ischemic stroke or TIA. Urgent and intensified therapy may be reasonable in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Ischemia / complications*
  • Brain Ischemia / pathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mortality
  • Population Surveillance
  • Prognosis
  • Recurrence
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology*
  • Stroke / pathology
  • Time Factors

Grants and funding

This study was funded by the Ministry of Science and Technology and the Ministry of Health of the People’s Republic of China, grant no. National S&T Major Project of China (2013BAI09B03, 2012ZX09303-005-001, 2011BAI08B02), Beijing Municipal Science & Technology Commission (Z131100002613005), and in part by the S.H. Ho Cardiovascular Disease and Stroke Center of the Chinese University of Hong Kong. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.