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

Journal：J Stroke

Publication type: Article

IF(IF): 6.967

PMID: 33600702 Link To Pubmed Full text Download

Patients with acute ischemic stroke or transient ischemic attack (TIA) suffer from approximately 11- 16% risk of new stroke during the first 3 months after symptom onset. In recent years, there have been substantial decrease in the risk of stroke recurrence, mainly due to improvement of ischemic stroke and TIA management, especially increased adherence to guideline-based secondary prevention medications (e.g. antiplatelet, antihypertensive, antidiabetic, lipid-lowing and anticognitive treatment). However, the residual risk of stroke recurrence under persistent adherence to standard secondary prevention medications is not yet estimated. Furthermore, it is noted that despite administration of these evidence-based therapies, substantial residual risk of stroke recurrence persists, indicating that the current guideline-based interventions do not adequately account for all the pathways that lead to stroke recurrence. Besides traditional vascular risk factors, there may be other risk factors. We therefore evaluated the residual risk of new stroke in acute ischemic stroke or TIA under persistent standard secondary prevention care, and identify the risk factors of the residual risk, using data from CNSR3.

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 during hospitalization, at discharge, at 3, 6, and 12 months if eligible. The primary outcome was a new stroke at 12 months.