Impact of risk factors for recurrent ischemic stroke in Prasat Neurological Institute.

BACKGROUND Recurrent strokes are more likely to be more disabling or fatal than first-even strokes. The high frequency of recurrences underscores the importance ofsecondary prevention. OBJECTIVE Investigate risk factors of recurrent ischemic stroke and to compare the outcomes after treatment following the Thai stroke guideline between patients with recurrent ischemic stroke and patients without recurrent ischemic stroke. MATERIAL AND METHOD Sixty-seven patients with recurrent ischemic stroke and 167 patients without recurrent ischemic stroke were included in the present study. All patients were evaluated for demographic data, modifiable risk factors, and treatment. RESULTS Patients without recurrent ischemic stroke had better controlled level of systolic blood pressure, diastolic blood pressure, and higher high-density lipoprotein level than patients with recurrent ischemic stroke. Carotid stenosis was higher in patients with recurrent ischemic stroke (43.3% vs. 28.7%, p = 0.032). Patients with recurrent ischemic stroke received statin therapy (67.2% vs. 86.8%, p = 0.001) and folic acid (61.2% vs. 78.4%, p = 0.007) less than patients without recurrent ischemic stroke. The multivariate analysis showed that well controlled diastolic blood pressure (p = 0.014), higher level of high-density lipoprotein (p = 0. 010), and receiving of statin (p = 0.002) were associated with decreased incidence of recurrent ischemic stroke. CONCLUSION Well-controlled risk factors including blood pressure, fasting blood sugar, high-density lipoprotein, and low-density lipoprotein were crucial for the protection of recurrent ischemic stroke. Furthermore, the benefits of statin and folic acid therapies for the protection of recurrent ischemic stroke were emphasized