Evaluating the risk factors for ischemic or hemorrhagic stroke recurrence

This study investigated the risk factors for ischemic or hemorrhagic stroke recurrence and the impact of antiplatelet therapy in patients with intracranial hemorrhage (ICH; brain bleed). The data showed that the risk of stroke recurrence is high in these patients. Hypertension (high blood pressure) is a risk factor for ischemic and hemorrhagic stroke recurrence. Antiplatelet therapy does not decrease the risk of ischemic stroke recurrence but may decrease the risk of hemorrhagic stroke recurrence.

A stroke occurs when there is a disturbance in the blood supply to a part of the brain. An ischemic stroke happens when blood flow through an artery that supplies oxygen-rich blood to the brain becomes blocked. A hemorrhagic stroke occurs when a blood vessel bursts, leaking blood into the brain. Both types of stroke result in a lack of oxygen and nutrients reaching the brain tissue and can cause brain damage.

Patients with stroke are often treated with antiplatelet therapy. Antiplatelet therapy stops blood clots to get formed. Hypertension (high blood pressure) is known to be a major risk factor for a stroke. Patients who have had a stroke are at risk for stroke recurrence. However, the risk factors like hypertension for ischemic or hemorrhagic stroke recurrence and the impact of antiplatelet therapy in patients with ICH remain unclear.

This study involved 6180 patients with ICH. Patients were divided into two groups. Group 1 included 4120 patients who received antiplatelet therapy. Group 2 included 2060 patients who did not receive antiplatelet therapy. The average follow-up time was 5 years.

After 5 years, the recurrence rate of stroke was 13.1% (7.01% hemorrhagic stroke, and 6.12% ischemic stroke). The recurrence rate of stroke was 12.6% in group 1 and 13.3% in group 2.

Patients with hypertension were 1.87 times more likely to experience a hemorrhagic stroke and 2.68 times more likely to experience an ischemic stroke.

Patients who were older in age (>60 years old) were 2.99 times more likely to experience an ischemic stroke. An ischemic stroke was more likely in patients with diabetes (by 1.28 times), with an irregular heartbeat (by 1.97 times), with cardiovascular disease (by 1.42 times), and with an ischemic stroke history (by 1.68 times).

Antiplatelet therapy was associated with a 47% lower risk of a hemorrhagic stroke recurrence. However, antiplatelet therapy did not reduce the risk of ischemic stroke recurrence. 

This study concluded that the risk of stroke recurrence was high in patients with ICH. Hypertension was a risk factor for ischemic and hemorrhagic stroke recurrence. Antiplatelet therapy did not decrease the risk of ischemic stroke recurrence but may decrease the risk of hemorrhagic stroke recurrence.

This study looked back in time at medical records and only included patients from Taiwan. This study did not include data regarding deep hemorrhage or lobar hemorrhage. This study did not include information on stroke risk control, such as blood pressure, blood sugar, and blood lipid level, which might have affected the rate of stroke recurrence and stroke type.