Impact of Risk Factors for Recurrent Ischemic Stroke in Prasat Neurological Institute
Narupat Suanprasert MD*, Tassanee Tantirithisak MD*
Affiliation : *Prasat Neurological Institute, Bangkok, Thailand
Background : Recurrent strokes are more likely to be more disabling or fatal than first-even strokes. The high frequency of
recurrences underscores the importance of secondary 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.
Keywords : Recurrent ischemic stroke, Risk factors
