Predictors of recurrent ischemic stroke in a sample of Egyptian stroke patients

Abstract

Abstract Background Stroke is the third leading cause of mortality and a major cause of disability worldwide. Patients who experienced a first ischemic stroke are at high risk of recurrence with estimated risk of 8–14% within the first year. Our aim is to assess predictors of recurrent ischemic stroke and to estimate the relative prevalence in a sample of Egyptian stroke patients. Methods This study included 96 subjects divided into 3 groups. Group 1 included 32 subjects with first time stroke, group 2 included 32 subjects with recurrent stroke, and group 3 included 32 healthy volunteers. Laboratory, neuroimaging investigations were done to groups 1, 2 while laboratory investigations were done only to group 3. Results The relative prevalence of recurrent ischemic stroke was 21%. Factors significantly associated with recurrent ischemic stroke (p ≤ 0.05) include hypertension, transient ischemic attack (TIA), increased carotid intimal medial thickness (IMT), and multiple infarctions. Sensitivity analysis showed that age (cutoff 60 years) was the only predictor of recurrent stroke. Logistic regression showed that smoking and diabetes mellitus (DM) were independent predictors of recurrent stroke. Neutrophil–lymphocytic ratio NLR was significantly higher in both first and recurrent stroke compared to controls. The most common TOAST subtype was large artery atherosclerosis (LAA) in first time stroke and cardio-embolic (CE) in recurrent stroke. Conclusion Significant predictors of recurrent ischemic stroke include old age, diabetes mellitus, smoking and dilated left atrium. NLR was significantly higher in both first and recurrent ischemic stroke compared to controls. Cardioembolic stroke was the most common TOAST subtype in recurrent ischemic stroke.

Keywords

• Recurrent stroke
• Ischemic stroke
• Predictors
• Risk factors
• Neutrophil/lymphocyte ratio