Development and validation of nomograms for predicting stroke recurrence after firstepisode ischemic stroke / 南方医科大学学报

OBJECTIVE@#To explore the risk factors for recurrence in first-episode ischemic stroke survivors and establish a model for predicting stroke recurrence using a nomogram.@*METHODS@#We collected the data from a total of 821 first-episode ischemic stroke survivors admitted in the Department of Neurology, West China Hospital, Sichuan University from January, 2010 to December, 2018. R software was used for random sampling of the patients, and 70% of the patients were included in the training set to establish the prediction model and 30% were included in the validation set. Cox proportional risk regression model was used to analyze the factors affecting stroke recurrence, and R software rms package was used to construct the histogram and establish the visual prediction model. C-index and calibration curve were used to evaluate the performance of the model for predicting stroke occurrence.@*RESULTS@#Among the 821 survivors, the recurrence rate was 16.81% at 3 years and 19.98% at 5 years. Multivariate analysis of the training set by Cox regression model showed that an age over 65 years (HR= 2.596, P=0.024), an age of 45-64 years (HR=2.510, P=0.006), a mRS score beyond 3 (HR=2.284, P=0.004) and a history of coronary heart disease (HR=1.353, P=0.034) were all risk factors for stroke recurrence. The C-indexes of the nomogram for the 3-and 5-year relapse prediction model were 0.640 and 0.671, respectively.@*CONCLUSION@#Age, mRS score and peripheral vascular disease are the factors affecting stroke recurrence in first-episode ischemic stroke survivors, and the nomogram has a high discrimination and predictive power for predicting ischemic stroke recurrence.

Effect of metabolic syndrome and related factors on recurrence of ischemic stroke / 重庆医学

Objective To investigate the relationship between metabolic syndrome and related factors and recurrence of ischemic stroke.Methods 90 in-and out-patients with ischemic stroke in Jiangbei District Hospital of Traditional Chinese Medicine during May 2013 and May 2014 were enrolled.In 90 cases,4 patients with cerebral hemorrhage were excluded.Basic data of the 86 patients were investigated,which including gender,age,abdominal circumference,smoking,drinking,family history of stroke,diabetes,hypertension,hyperlipidemia,a history of atrial fibrillation,transient ischemic attacks,fasting blood glucose,triglyceride,cholesterol,uric acid,homocysteine,urinary protein-creatine ratio,carotid ultrasound examination.We investigated patients with or without recurrent stroke during one year of telephone visit and follow-up.Patients with recurrent stroke were investigated.Results During the one year follow-up,24 cases in the 86 patients with ischimic stroke were recurrent,the recurrence rate was 27.9 ％.2 cases in the recurrent patients died because of massive cerebral infarction,accounted for 8.3％ of the patients with recurrent stroke.According to Chi-square test,smoking,high fasting plasma blood glucose,hypertension,elevated low density lipoprotein cholesterol,high uric acid,high homocysteine and carotid atherosclerosis all had correlation with recurrent stroke(P＜0.05).In this logistic-regression model,smoking,high fasting plasma blood glucose,hypertension,elevated low density lipoprotein cholesterol,high uric acid,high homocysteine and carotid atherosclerosis were all predictors for recurrence of ischemic stroke.Conclusion Cntrolling the risk factors after the first stroke as a long term strategy has important clinical significance for secondary prevention of ischemic stroke.