The long term risk of vascular events following stroke in young adults

This trial aimed to determine the long-term risk of vascular event in ischemic stroke patients and whether patients of a certain subgroup were more at risk. The authors concluded that there was still a risk of vascular event for these patients 15 years after stroke, in particular patients with previous cardioembolism and large-artery atherosclerosis.

An ischemic stroke (IS) occurs when a blood clot blocks blood flow to the brain. This type of stroke is occurring more commonly in younger patients within the past few years. Studies have shown that IS patients are at a higher risk of secondary vascular events. These studies, however, have provided inconclusive results for determining the long-term risk and whether certain subgroups of patients are at a higher risk. Therefore, analysis from longer follow-up data is needed to calculate this risk.

This study included 970 patients, aged 15-49, who presented with ischemic stroke. Patients underwent regular follow-ups where cardiac (related to the heart), arterial (related to arteries) and venous (related to veins) events were recorded.

The risk of any vascular event within 15 years after IS was 35.7%.

The risk of arterial event was 33.7%, venous event was 3.9%, cardiac event was 20.8% and recurrent stroke was 19.1%. The subgroup at highest risk of vascular event was those with previous cardioembolism (blood clot in the heart). The subgroup at the highest risk of recurrent stroke was those with large-artery atherosclerosis (hardening of the arteries).

The authors concluded that the risk of vascular event after IS in young patients remained high 15 years after first stroke. This risk was higher in patients with cardioembolism and large-artery atherosclerosis.