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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Yuesong Pan (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Zixiao Li (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Jiejie Li (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Aoming Jin (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Jinxi Lin (epartment of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Jing Jing (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Hao Li (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Xia Meng (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Yilong Wang (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Yongjun Wang (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제23권 제1호
발행연도
2021.1
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51 - 60 (10page)

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Background and Purpose: Despite administration of evidence-based therapies, residual risk of stroke recurrence persists. This study aimed to evaluate the residual risk of recurrent stroke in acute ischemic stroke or transient ischemic attack (TIA) with adherence to guideline-based secondary stroke prevention and identify the risk factors of the residual risk. Methods: Patients with acute ischemic stroke or TIA within 7 hours were enrolled from 169 hospitals in Third China National Stroke Registry (CNSR-III) in China. Adherence to guideline-based secondary stroke prevention was defined as persistently receiving all of the five secondary prevention medications (antithrombotic, antidiabetic and antihypertensive agents, statin and anticoagulants) during hospitalization, at discharge, at 3, 6, and 12 months if eligible. The primary outcome was a new stroke at 12 months. Results: Among 9,022 included patients (median age 63.0 years and 31.7% female), 3,146 (34.9%) were identified as adherence to guideline-based secondary prevention. Of all, 864 (9.6%) patients had recurrent stroke at 12 months, and the residual risk in patients with adherence to guidelinebased secondary prevention was 8.3%. Compared with those without adherence, patients with adherence to guideline-based secondary prevention had lower rate of recurrent stroke (hazard ratio, 0.85; 95% confidence interval, 0.74 to 0.99; P=0.04) at 12 months. Female, history of stroke, interleukin- 6 ≥5.63 ng/L, and relevant intracranial artery stenosis were independent risk factors of the residual risk. Conclusions: There was still a substantial residual risk of 12-month recurrent stroke even in patients with persistent adherence to guideline-based secondary stroke prevention. Future research should focus on efforts to reduce the residual risk.
#Outcome #Secondary prevention #Risk factors #Stroke

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참고문헌 (31)

참고문헌 신청
Chen Y / 2020 / Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0.5 million Chinese adults / Lancet Glob Health 8:e580~e590 google schola Beilei Lin / 2021 / Cumulative risk of stroke recurrence over the last 10 years: a systematic review and meta-analysis / Neurological Sciences 42(1):61~71 Crossref Wang Y / 2018 / Effect of a multifaceted quality improvement intervention on hospital personnel adherence to performance measures in patients with acute ischemic stroke in China : a randomized clinical trial / JAMA 320:245~254 google schola Amarenco P / 2016 / One-year risk of stroke after transient ischemic attack or minor stroke / N Engl J Med 374:1533~1542 google schola Xie X / 2019 / Prognostic value of international normalized ratio in ischemic stroke patients without atrial fibrillation or anticoagulation therapy / J Atheroscler Thromb 26:378~387 google schola

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