Abstract P469: Risk of Long-Term All-Cause Mortality After Incident Ischemic Stroke of Different Severity in the Atherosclerosis Risk in Communities Study
| Autor: | Jinyu Chen, James R Pike, Michelle C Johansen, Priya Palta, Josef Coresh, Rebecca F Gottesman, Silvia Koton |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Circulation. 147 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Background: Stroke is associated with increased risk of mortality. However, studies on the association between stroke severity and mortality using prospective cohort data with details on cardiovascular risk factors at midlife have not been published in recent years in the US. We studied the association between stroke severity and subsequent all-cause mortality in the Atherosclerosis Risk in Communities Study (ARIC) study. Hypothesis: Risk of all-cause mortality increases after incident ischemic strokes with greater risk at higher stroke severity. Methods: Severity of incident ischemic strokes in ARIC from 1987 to 2018 was assessed through review of hospital records using the National Institutes of Health Stroke Scale (NIHSS) and categorized as minor, (NIHSS ≤5), mild (6-10), moderate (11-15), and severe (≥16). Deaths were ascertained through linkage with the National Death Index. We used Cox proportional hazard models adjusted for demographic variables and baseline risk factors to determine the hazard ratios (HRs) for all-cause mortality associated with each category of stroke severity, in participants after incident ischemic stroke compared to those who remained stroke-free throughout the study period. Results: Among 15661 participants free of stroke at baseline (1987-1989), 1036 developed incident ischemic stroke. There were 757 deaths among participants with incident ischemic stroke during the follow-up after stroke (median=16.1 years). Mean baseline age was 54.16 years, 55.2% women and 26.8% black participants. Cox proportional HRs of mortality after incident ischemic stroke controlling for demographics (Model 1) and further adjusted for risk factors at midlife (age 45-64) are displayed in Table 1. Conclusion: Compared to participants free from ischemic stroke, after adjustment for cardiovascular risk factors at midlife, risk of all-cause mortality was 2 to 12-folds higher in ARIC participants after incident ischemic stroke, with a greater risk of mortality observed in those with higher stroke severity. |
| Databáze: | OpenAIRE |
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