Long-term mortality in patients with coexisting potential causes of ischemic stroke

Young Dae Kim, Myoung Jin Cha, Jinkwon Kim, Dong Hyun Lee, Hye Sun Lee, Chung Mo Nam, Hyo Suk Nam, Jihoe Heo

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Abstract

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.

Original languageEnglish
Pages (from-to)541-546
Number of pages6
JournalInternational Journal of Stroke
Volume10
Issue number4
DOIs
Publication statusPublished - 2015 Jun 1

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Atherosclerosis
Arteries
Stroke
Mortality
Confidence Intervals
Death Certificates
Secondary Prevention
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Neurology

Cite this

Kim, Young Dae ; Cha, Myoung Jin ; Kim, Jinkwon ; Lee, Dong Hyun ; Lee, Hye Sun ; Nam, Chung Mo ; Nam, Hyo Suk ; Heo, Jihoe. / Long-term mortality in patients with coexisting potential causes of ischemic stroke. In: International Journal of Stroke. 2015 ; Vol. 10, No. 4. pp. 541-546.
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title = "Long-term mortality in patients with coexisting potential causes of ischemic stroke",
abstract = "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.",
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Long-term mortality in patients with coexisting potential causes of ischemic stroke. / Kim, Young Dae; Cha, Myoung Jin; Kim, Jinkwon; Lee, Dong Hyun; Lee, Hye Sun; Nam, Chung Mo; Nam, Hyo Suk; Heo, Jihoe.

In: International Journal of Stroke, Vol. 10, No. 4, 01.06.2015, p. 541-546.

Research output: Contribution to journalArticle

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AU - Cha, Myoung Jin

AU - Kim, Jinkwon

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AU - Nam, Chung Mo

AU - Nam, Hyo Suk

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N2 - 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.

AB - 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.

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