Brown DL et al. (2005) Recurrent stroke risk is higher than cardiac event risk after initial stroke/transient ischemic attack. Stroke 36: 1285–1287

A recent retrospective study of patients who had suffered a first ischemic stroke or transient ischemic attack (TIA), investigated the relative incidence of subsequent cerebrovascular and cardiac events.

Brown et al. investigated the hospital records of 1,923 male and female patients (mean age 77) who had suffered an ischemic stroke or TIA, and recorded the nature of the first cardiac or cerebrovascular adverse event to occur during a 30-month follow-up period. Adverse events noted were cardiac events, myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, and ischemic stroke. Cumulative incidence estimates compared cardiac events and stroke as secondary events.

During the follow-up period, 239 patients had a stroke as their first event, and 172 patients had a cardiac event (10 patients suffered both a stroke and cardiac event on the same day). Recurrent strokes were more frequent than cardiac events at all times during the follow-up period—at 30 days, 2.5% and 0.8% of patients had suffered a stroke and cardiac event, respectively. By 6 months this had risen to 6.6% and 2.6%, and at 2 years 11.8% had suffered a stroke, and 7.7% a cardiac event.

The authors conclude that the risk of having a stroke following an initial stroke or TIA, is greater than the risk of having a cardiac event, and that consequently there are implications for the selection of appropriate prophylactic therapy.