Major cardiovascular events and all-cause mortality after ischemic stroke in central Norway – A three-year prospective multicenter study

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-05-22 DOI:10.1016/j.jstrokecerebrovasdis.2025.108356

Ailan Phan , Bent Indredavik , Stian Lydersen , Torunn Askim , Torgeir Wethal

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引用次数: 0

Abstract

Background

A substantial decline in the incidence of stroke and ischemic heart disease during the last decade is probably due to improved preventive treatment and a reduction in cardiovascular risk factors. Updated estimates on long-term outcomes following first-ever ischemic stroke are therefore limited.

Purpose

To assess the incidence of major cardiovascular events and all-cause mortality three years post-stroke, and to evaluate the impact of modifiable cardiovascular and other prognostic factors.

Methods

MIDNOR STROKE is a multicenter prospective study including patients with first-ever ischemic stroke admitted to stroke units in Central Norway during 2015-2017. Data were collected during the hospital stay. Information on major cardiovascular events and survival three years post-stroke was retrieved from national medical registries. Competing risk models were used to analyze cardiovascular events. All-cause mortality was analyzed by using Kaplan-Meier and Cox regression.

Results

Among 787 included participants, the cumulative incidence of major cardiovascular events was 15.0 % (95 % CI: 12.0–17.0 %), with recurrent stroke as the most common event. The all-cause mortality rate was 18.0 % (95 % CI: 15.0–20.0 %). Coronary artery disease was associated with a higher risk of major vascular events HR: 1.59, 95 % CI: 1.06, 2.38) and all-cause death (HR: 1.66, 95 % CI: 1,11, 2.50). NIHSS at day 1 predicted all-cause mortality (HR: 1.08, 95 % CI: 1.05, 1.10).

Conclusion

Three-year survival rates post-stroke were higher compared to previous reports; however, the risk of major cardiovascular events remains substantial, affecting 15 % of stroke survivors within three years.

Reducing cardiac disease risk and interventions aimed at minimizing stroke severity may improve long-term stroke outcomes.

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挪威中部缺血性卒中后主要心血管事件和全因死亡率-一项为期三年的前瞻性多中心研究

背景：在过去十年中，中风和缺血性心脏病发病率的大幅下降可能是由于预防治疗的改善和心血管危险因素的减少。因此，对首次缺血性卒中后长期预后的最新估计有限。目的：评估脑卒中后3年主要心血管事件和全因死亡率的发生率，并评估可改变的心血管和其他预后因素的影响。方法：MIDNOR卒中是一项多中心前瞻性研究，包括2015-2017年挪威中部卒中单位收治的首次缺血性卒中患者。在住院期间收集数据。主要心血管事件和卒中后3年生存率的信息从国家医疗登记处检索。竞争风险模型用于分析心血管事件。全因死亡率采用Kaplan-Meier和Cox回归分析。结果：在纳入的787名参与者中，主要心血管事件的累积发生率为15.0% (95% CI: 12.0-17.0%)，复发性卒中是最常见的事件。全因死亡率为18.0% （95% CI: 15.0-20.0%）。冠状动脉疾病与主要血管事件（HR: 1.59, 95% CI: 1.06, 2.38）和全因死亡（HR: 1.66, 95% CI: 1,11, 2.50）的高风险相关。第1天的NIHSS预测全因死亡率（HR: 1.08, 95% CI: 1.05, 1.10）。结论：脑卒中后三年生存率高于既往报道；然而，主要心血管事件的风险仍然很大，在三年内影响15%的中风幸存者。降低心脏疾病的风险和干预措施，旨在最大限度地减少中风的严重程度可能改善中风的长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.