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- Title
Long-term mortality in patients with coexisting potential causes of ischemic stroke.
- Authors
Kim, Young Dae; Cha, Myoung-Jin; Kim, Jinkwon; Lee, Dong Hyun; Lee, Hye Sun; Nam, Chung Mo; Nam, Hyo Suk; Heo, Ji Hoe
- Abstract
Background Multiple potential causes of stroke may coexist in ischemic stroke patients, which may affect long-term outcome. Aim We investigated whether there are differences in long-term mortality among stroke patients with coexisting potential causes. Methods We evaluated the long-term all-cause mortality and stroke or cardiovascular mortality of ischemic stroke patients with multiple potential stroke mechanisms, large artery atherosclerosis, cardioembolism, small vessel occlusion, and negative evaluation admitted to a single center between January 1996 and December 2008. Mortality data were obtained from a National Death Certificate system. Results Total 3533 patients were included in this study: 286 multiple potential mechanisms (138 large artery atherosclerosis + cardioembolism, 105 small vessel occlusion + large artery atherosclerosis, 43 small vessel occlusion + cardioembolism), 1045 large artery atherosclerosis, 701 cardioembolism, 606 small vessel occlusion, and 895 negative evaluation. During a mean follow-up of 3·9 years, as referenced to small vessel occlusion mortality rate, the adjusted mortality hazard ratio was 4·387 (95% confidence interval 3·157-6·096) for large artery atherosclerosis + cardioembolism group, 3·903 (95% confidence interval 3·032-5·024) for cardioembolism group, and 2·121 (95% confidence interval 1·655-2·717) for large artery atherosclerosis. The risk of long-term ischemic stroke mortality or cardiovascular mortality also showed comparable findings: highest in the large artery atherosclerosis + cardioembolism, followed by cardioembolism, and large artery atherosclerosis groups. However, the outcome of small vessel occlusion + large artery atherosclerosis or small vessel occlusion + cardioembolism group was not significantly different from that of small vessel occlusion. Conclusions Coexisting potential causes of ischemic stroke impact on long-term mortality. Identification of coexisting potential causes may help to predict stroke outcomes and to guide planning secondary prevention strategies.
- Subjects
ISCHEMIA; STROKE risk factors; CARDIOVASCULAR disease related mortality; ATHEROSCLEROSIS; HEALTH outcome assessment; EMBOLISMS; DISEASE risk factors
- Publication
International Journal of Stroke, 2015, Vol 10, Issue 4, p541
- ISSN
1747-4930
- Publication type
Article
- DOI
10.1111/ijs.12013