Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Journal of Stroke and Cerebrovascular Diseases

Publication type: Original Contributions

IF(IF): 2.677

PMID: 34823089 Link To Pubmed Full text Download

Aim We aim to investigate whether patients with family history of stroke has higher risk of recurrence after acute ischemic stroke (AIS) and transient ischemic attack (TIA). We also investigate whether the association between family history of stroke and recurrent stroke has stroke subtype-specificity. Background Stroke remains a leading cause of mortality and disability worldwide, especially in China. Even with optimal secondary preventive treatment, many patients will remain high risk of recurrent events, whether family history of stroke contributed to risk of stroke recurrence still unclear. Studies have confirmed family history of disease represent genetic predisposition, and familial aggregation of stroke suggested that genetic factors may play an important role in the occurrence of ischemic stroke (IS). Case-controls studies and family studies suggested there is significant association between family history of stroke and risk of IS. However, limited studies investigated the effects of family history of stroke on clinical outcome after AIS/TIA, and conclusions remained inconsistent. Most studies were investigated in European and American population, while there is a relatively lack of Chinese data. In addition, few studies analyzed whether these associations had subtype-specific predisposition. Limited previous evidence to prove the relationship between family history of stroke and prognosis, the inconsistencies due to difference in study design, limited sample size, and lack of data of stroke subtypes and image information. The third china national stroke registry (CNSR-III) is a large scale nationwide registry in China which enrolled 15166 stroke patients from 201 hospitals. Information including clinical features, follow-up data and detailed imaging data (MRI OR CT) were collected. Accordingly, we aim to investigate whether patients with family history of stroke had higher risk of recurrence, and investigate whether this association has stroke subtype-specificity based on CNSR-III.

Study subjects This study based on the database of CNSR-III, which is a prospective, multicenter, nationwide, and acute stroke registry in China. Clinical information was acquired directly from the registry database, including data on age, sex, body mass index, laboratory findings, vascular risk factors, stroke profile (NIHSS score at admission, history of stroke among first-degree relatives, and stroke recurrence. stroke subtype was centralized analyzed by the image research center after image data collected in DICOM format on discs. Statistical analyses Demographic and clinical characteristics were compared according to the patient’s family history of stroke. In these comparisons, Pearson χ2 test was used for categorical variables, and Student t test or one-way ANOVA was used for continuous variables. Table 1 shows baseline characteristics of AIS/TIA patients with or without family history of stroke. Table 2 shows the associations between family history of stroke and stroke recurrence within 1 year by performing Cox proportional hazards regression analyses. Table 3 to investigate whether the effect of family history of stoke on stroke recurrence has subtype-specificity, we performing Cox proportional hazards regression analyses in patients with different stroke subtype. Table 4 a subgroup analysis will be performed to explore the effect of family history of stroke on stroke recurrence after the standard secondary prevention treatment.