One-year atherothrombotic vascular events rates in outpatients with recent non-cardioembolic ischemic stroke: The EVEREST (Effective Vascular Event REduction after STroke) registry

Norihiro Suzuki, Motoki Sato, Kiyohiro Houkin, Yasuo Terayama, Shinichiro Uchiyama, Hiroyuki Daida, Hiroshi Shigematsu, Shinya Goto, Kortaro Tanaka, Hideki Origasa, Susumu Miyamoto, Kazuo Minematsu, Masayasu Matsumoto, Yasushi Okada

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Patients with recent ischemic stroke may have higher risk of atherothrombosis than stable patients with established vascular events. Our aims were to investigate 1-year atherothrombotic vascular event rates and to assess the risk factors for recurrent ischemic stroke in this population. Methods: This prospective cohort study was conducted between January 2007 and July 2009 at 313 hospitals in Japan. Outpatients who were at least 45 years of age and who had received oral antiplatelet therapy were enrolled within 2 weeks to 6 months from the last onset of noncardioembolic ischemic stroke. At 12 ± 3 months after enrollment, data on presence/absence of atherothrombotic vascular events were collected. The primary endpoint was the occurrence of fatal or nonfatal ischemic stroke. Results: A total of 3452 patients were enrolled, and 3411 patients who had baseline data were included in the analysis. The 1-year event rate was 3.81% (95% confidence interval 3.15-4.48%) for fatal or nonfatal ischemic stroke and 0.84% (95% confidence interval 0.52-1.15%) for all-cause mortality. The annual rate of recurrent ischemic stroke was significantly higher in patients who had ischemic stroke at least twice than in patients who had first-ever ischemic stroke (5.02% vs 3.59%; P =.0313). In the multivariable Cox regression analysis, recurrent ischemic stroke was significantly associated with age (P =.0033), the presence of diabetes (P =.0129), and waist circumference ≥80 cm (P =.0056). Conclusions: Patients with recent ischemic stroke have a higher risk of stroke recurrence than stable patients enrolled in the REduction of Atherothrombosis for Continued Health (REACH) registry even though they received antiplatelet therapy. The rigorous management of risk factors is needed.

Original languageEnglish
Pages (from-to)245-253
Number of pages9
JournalJournal of Stroke and Cerebrovascular Diseases
Volume21
Issue number4
DOIs
Publication statusPublished - 2012 May

Fingerprint

Blood Vessels
Registries
Outpatients
Stroke
Confidence Intervals
Waist Circumference
Japan
Cohort Studies
Regression Analysis
Prospective Studies
Recurrence
Mortality
Health
Therapeutics

Keywords

  • Antiplatelet agents
  • cohort study
  • ischemic stroke
  • risk factors
  • secondary prevention

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

One-year atherothrombotic vascular events rates in outpatients with recent non-cardioembolic ischemic stroke : The EVEREST (Effective Vascular Event REduction after STroke) registry. / Suzuki, Norihiro; Sato, Motoki; Houkin, Kiyohiro; Terayama, Yasuo; Uchiyama, Shinichiro; Daida, Hiroyuki; Shigematsu, Hiroshi; Goto, Shinya; Tanaka, Kortaro; Origasa, Hideki; Miyamoto, Susumu; Minematsu, Kazuo; Matsumoto, Masayasu; Okada, Yasushi.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 21, No. 4, 05.2012, p. 245-253.

Research output: Contribution to journalArticle

Suzuki, N, Sato, M, Houkin, K, Terayama, Y, Uchiyama, S, Daida, H, Shigematsu, H, Goto, S, Tanaka, K, Origasa, H, Miyamoto, S, Minematsu, K, Matsumoto, M & Okada, Y 2012, 'One-year atherothrombotic vascular events rates in outpatients with recent non-cardioembolic ischemic stroke: The EVEREST (Effective Vascular Event REduction after STroke) registry', Journal of Stroke and Cerebrovascular Diseases, vol. 21, no. 4, pp. 245-253. https://doi.org/10.1016/j.jstrokecerebrovasdis.2012.01.010
Suzuki, Norihiro ; Sato, Motoki ; Houkin, Kiyohiro ; Terayama, Yasuo ; Uchiyama, Shinichiro ; Daida, Hiroyuki ; Shigematsu, Hiroshi ; Goto, Shinya ; Tanaka, Kortaro ; Origasa, Hideki ; Miyamoto, Susumu ; Minematsu, Kazuo ; Matsumoto, Masayasu ; Okada, Yasushi. / One-year atherothrombotic vascular events rates in outpatients with recent non-cardioembolic ischemic stroke : The EVEREST (Effective Vascular Event REduction after STroke) registry. In: Journal of Stroke and Cerebrovascular Diseases. 2012 ; Vol. 21, No. 4. pp. 245-253.
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abstract = "Background: Patients with recent ischemic stroke may have higher risk of atherothrombosis than stable patients with established vascular events. Our aims were to investigate 1-year atherothrombotic vascular event rates and to assess the risk factors for recurrent ischemic stroke in this population. Methods: This prospective cohort study was conducted between January 2007 and July 2009 at 313 hospitals in Japan. Outpatients who were at least 45 years of age and who had received oral antiplatelet therapy were enrolled within 2 weeks to 6 months from the last onset of noncardioembolic ischemic stroke. At 12 ± 3 months after enrollment, data on presence/absence of atherothrombotic vascular events were collected. The primary endpoint was the occurrence of fatal or nonfatal ischemic stroke. Results: A total of 3452 patients were enrolled, and 3411 patients who had baseline data were included in the analysis. The 1-year event rate was 3.81{\%} (95{\%} confidence interval 3.15-4.48{\%}) for fatal or nonfatal ischemic stroke and 0.84{\%} (95{\%} confidence interval 0.52-1.15{\%}) for all-cause mortality. The annual rate of recurrent ischemic stroke was significantly higher in patients who had ischemic stroke at least twice than in patients who had first-ever ischemic stroke (5.02{\%} vs 3.59{\%}; P =.0313). In the multivariable Cox regression analysis, recurrent ischemic stroke was significantly associated with age (P =.0033), the presence of diabetes (P =.0129), and waist circumference ≥80 cm (P =.0056). Conclusions: Patients with recent ischemic stroke have a higher risk of stroke recurrence than stable patients enrolled in the REduction of Atherothrombosis for Continued Health (REACH) registry even though they received antiplatelet therapy. The rigorous management of risk factors is needed.",
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T1 - One-year atherothrombotic vascular events rates in outpatients with recent non-cardioembolic ischemic stroke

T2 - The EVEREST (Effective Vascular Event REduction after STroke) registry

AU - Suzuki, Norihiro

AU - Sato, Motoki

AU - Houkin, Kiyohiro

AU - Terayama, Yasuo

AU - Uchiyama, Shinichiro

AU - Daida, Hiroyuki

AU - Shigematsu, Hiroshi

AU - Goto, Shinya

AU - Tanaka, Kortaro

AU - Origasa, Hideki

AU - Miyamoto, Susumu

AU - Minematsu, Kazuo

AU - Matsumoto, Masayasu

AU - Okada, Yasushi

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Y1 - 2012/5

N2 - Background: Patients with recent ischemic stroke may have higher risk of atherothrombosis than stable patients with established vascular events. Our aims were to investigate 1-year atherothrombotic vascular event rates and to assess the risk factors for recurrent ischemic stroke in this population. Methods: This prospective cohort study was conducted between January 2007 and July 2009 at 313 hospitals in Japan. Outpatients who were at least 45 years of age and who had received oral antiplatelet therapy were enrolled within 2 weeks to 6 months from the last onset of noncardioembolic ischemic stroke. At 12 ± 3 months after enrollment, data on presence/absence of atherothrombotic vascular events were collected. The primary endpoint was the occurrence of fatal or nonfatal ischemic stroke. Results: A total of 3452 patients were enrolled, and 3411 patients who had baseline data were included in the analysis. The 1-year event rate was 3.81% (95% confidence interval 3.15-4.48%) for fatal or nonfatal ischemic stroke and 0.84% (95% confidence interval 0.52-1.15%) for all-cause mortality. The annual rate of recurrent ischemic stroke was significantly higher in patients who had ischemic stroke at least twice than in patients who had first-ever ischemic stroke (5.02% vs 3.59%; P =.0313). In the multivariable Cox regression analysis, recurrent ischemic stroke was significantly associated with age (P =.0033), the presence of diabetes (P =.0129), and waist circumference ≥80 cm (P =.0056). Conclusions: Patients with recent ischemic stroke have a higher risk of stroke recurrence than stable patients enrolled in the REduction of Atherothrombosis for Continued Health (REACH) registry even though they received antiplatelet therapy. The rigorous management of risk factors is needed.

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KW - Antiplatelet agents

KW - cohort study

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KW - risk factors

KW - secondary prevention

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