Two-Year Recurrence After First-Ever Stroke in a General Population of 1.4 Million Japanese Patients　― The Shiga Stroke and Heart Attack Registry Study

Background:Despite many effective strategies for the prevention of recurrent stroke, individuals who survive an initial stroke have been shown to be at high risk of recurrent stroke. The aim of this study was to investigate the current status of stroke recurrence after first-ever stroke using a popu...

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Bibliographic Details
Published in:Circulation Journal 2020/05/25, Vol.84(6), pp.943-948
Main Authors: Takashima, Naoyuki, Arima, Hisatomi, Kita, Yoshikuni, Fujii, Takako, Tanaka-Mizuno, Sachiko, Shitara, Satoshi, Kitamura, Akihiro, Miura, Katsuyuki, Nozaki, Kazuhiko, on behalf of the Shiga Stroke and Heart Attack Registry Group
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Asian
Brain Ischemia - diagnosis
Brain Ischemia - mortality
Brain Ischemia - therapy
Female
Humans
Intracranial Hemorrhages - diagnosis
Intracranial Hemorrhages - mortality
Intracranial Hemorrhages - therapy
Japan - epidemiology
Male
Middle Aged
Population studies
Recurrence
Recurrence event
Registries
Risk Factors
Stroke
Stroke - diagnosis
Stroke - mortality
Stroke - therapy
Time Factors
Treatment Outcome
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Summary:Background:Despite many effective strategies for the prevention of recurrent stroke, individuals who survive an initial stroke have been shown to be at high risk of recurrent stroke. The aim of this study was to investigate the current status of stroke recurrence after first-ever stroke using a population-based stroke registry in Japan.Methods and Results:As part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry is an ongoing population-based stroke registry study that covers approximately 1.4 million residents of Shiga Prefecture, Japan. A total of 1,883 first-ever stroke survivors at 28 days was registered in 2011 and followed-up until the end of 2013. Recurrence was defined as any type of stroke after 28 days from the onset of an index event. Two-year cumulative recurrence rates were estimated using cumulative incidence function methods. Over a mean 2.1-year follow-up period, 120 patients experienced recurrent stroke and 389 patients died without recurrence. The 2-year cumulative recurrence rate was higher in patients with index ischemic stroke (6.8%) than in those with index hemorrhagic stroke (3.8%).Conclusions:Two-year cumulative recurrence rate after first-ever stroke remained high, particularly among patients with ischemic stroke, in the present population-based registry study in a real-world setting in Japan. Further intensive secondary prevention strategies are required for these high-risk individuals.
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-20-0024