Abstract

Factors related to recurrent ischemic stroke in difference subtypes.

Hantham P

 Tubtimgomonkul W

Unapac N

 Samseethong T 

recurrence, ischemic stroke, risk factor

Introduction: Ischemic stroke is the most substantial of mortality caused by non-communicable disease (NCDs).  According to the TOAST classification, the risk factors of different etiological mechanism ischemic stroke were limited. The aims of study were to evaluate risk factors that associated with stroke subtypes and collected management for secondary prevention of ischemic stroke. Methods: This study is a retrospective study. All patients were admitted at Sunpasitthiprasong hospital and classified three subtypes according to the TOAST criteria: large vessel atherosclerosis (LAA), small vessel atherosclerosis (SAO), cardiac embolism (CE). The risk factors of different subtypes were analyzed by using Chi-square test. Results: A total of 192 patients with recurrent stroke were included in the study and classified into subtypes, 73 from LAA (38.02%), 16 from CE (8.33%) and 103 from SAO (53.65%). Baseline characteristic of the body mass index (BMI), hypertension (HTN) and dyslipidemia (DLP) were statistically significant differences in all three subtypes (p<0.05). LAA and SAO were higher in proportion of HTN and DLP than CE. CE subtype had more elders (mean 68.7 years) than others and had the highest proportion of atrial fibrillation (AF) (93.8%). Uncontrolled of Systolic blood pressure (SBP) was significant different between previous stroke and recurrent stroke in LAA and SAO (p<0.05). Recurrent stroke patients who were switched treatment from antiplatelet monotherapy to increase another antiplatelet or dual antiplatelet were increased in LAA and SAO subtype (p<0.01). Conclusion: BMI, HTN, DLP and AF are associated with the recurrence of ischemic stroke among different subtype. Switching therapy antiplatelet or dual antiplatelet therapy was used management in recurrent stroke patients.