İskemik inmenin erken dönem tekrarinda risk faktörleri

Year 2023, Volume: 16 Issue: 1, 9 - 12, 31.01.2023

Nevzat Uzuner , Gülnur Tekgöl Uzuner , Yasemin Dinc

https://doi.org/10.31362/patd.1114644

Abstract

Amaç:
İskemik inme gelişen akut ve koruyucu tedavilere rağmen, iskemik inmenin tekrarlaması nedeniyle de yüksek ölüm ve morbidite nedeni olarak kalmaya devam etmektedir. Genellikle kabul edilen görüş, ilk inmeye neden olan risk faktörlerinin, iskemik inme tekrarında da önemli olduğudur. Bizim çalışmamız erken dönem iskemik inme tekrarında yer alan risk faktörlerini belirlemek amacıyla yapılmıştır.

Yöntem:
İskemik inme hastalarını kendi inme veri tabanımızdan seçtik ve bu çalışmaya alınan hastalar içinde ilk inmeden sonraki dönemde 3 ay takip edilebilen ve incelemeleri eksiksiz olan 521 hasta analize dahil edilmişlerdir

Sonuçlar
Yetmiş bir hasta (%14) ilk inmeden sonraki 3 ay içerisinde tekrar inme geçirmişlerdir. Erken inme tekrarı için geçen ortalama süre 21 gündür. Erken inme için belirgin risk faktörleri koroner arter hastalığı (%43, p<0,016) ve konjestif kalp yetmezliği (%38, p<0,016) olarak saptanmıştır. Yaş, atriyal fibrilasyon, hipertansiyon, diabetes mellitus, hiperlipidemi, sigara, alkol kullanımı erken dönemde inme tekrarı için anlamlı risk faktörü olarak bulunmamıştır.

Tartışma
Uygun tedavilere rağmen, koroner arter hastalığı ve konjestif kalp yetmezliği inmeden sonraki erken dönemde inme tekrarı için önemli risk faktörleri olarak öne çıkmıştır ve bu konuya biraz daha fazla önem verilmesi gerektiğine işaret etmektedir.

Keywords

iskemik inme, risk faktörleri, inme tekrarı

Supporting Institution

yok

Risk factors of early recurrence of ischaemic stroke

Abstract

Background: Despite acute and preventive treatments for ischemic stroke, it remains a cause of high mortality and morbidity due to recurrence of ischemic stroke. The generally accepted point of view is that the risk factors that caused the initial stroke are also important in the recurrence of ischemic stroke. Our study was conducted to determine the risk factors involved in early ischemic stroke recurrence.
Method: We selected ischemic stroke patients from our own stroke database, and among the patients included in this study, 521 patients who could be followed up for 3 months after the first stroke and had complete examinations were included in the analysis.
Result: Seventy-one patients (14%) had another stroke within 3 months of the first stroke. The mean time to early stroke recurrence is 21 days. Significant risk factors for early stroke were coronary artery disease (43%, p<0.016) and congestive heart failure (38%, p<0.016). Age, atrial fibrillation, hypertension, diabetes mellitus, hyperlipidaemia, smoking, and alcohol use were not found to be significant risk factors for stroke recurrence in the early period.
Conclusion: Despite appropriate treatments, coronary artery disease and congestive heart failure have emerged as important risk factors for stroke recurrence in the early period after stroke, indicating that more attention should be paid to this issue.

Keywords

ischemic stroke, risk factors, stroke recurrence

References

• 1. Zheng S, Yao B. Impact of risk factors for recurrence after the first ischemic stroke in adults: A systematic review and meta-analysis. J Clin Neurosci 2019; 60: 24-30. https://doi.org/10.1016/j.jocn.2018.10.026
• 2. Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of ORG 10172 in Acute Stroke Treatment. Stroke. 1993; 24: 35–41.
• 3. J Bamford, P Sandercock, M Dennis, Warlow C, Burn J. Classification and natural history of clinically identifiable subtypes of cerebral infarction Lancet, 337 1991; 337: 1521-1526.
• 4. Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, Barker-Collo S, Moran AE, Sacco RL, Truelsen T, Davis S, Pandian JD, Naghavi M, Forouzanfar MH, Nguyen G, Johnson CO, Vos T, Meretoja A, Murray CJL, Roth GA, GBD 2013 Writing Group; GBD 2013 Stroke Panel Experts Group. Neuroepidemiology. 2015;45(3):161-76. doi: 10.1159/000441085
• 5. Kolmos M, Christoffersen L, Kruuse C. Recurrent Ischemic Stroke - A Systematic Review and Meta-Analysis. Journal of Stroke and Cerebrovascular Diseases, 2021; 30 (8): 105935 https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105935
• 6. Zheng S, Yao B. Impact of risk factors for recurrence after the first ischemic stroke in adults: A systematic review and meta-analysis. Journal of Clinical Neuroscience 019; 60: 24–30.
• 7. Rothwell PM, Algra A, Chen Z, Diener HC, Norrving B, Mehta Z. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. Lancet 2016; 388: 365-75.
• 8. Mohan KM, Wolfe CDA, Rudd AG, Heuschmann PU, Kolominsky-Rabas PL, Grieve AP. Risk and Cumulative Risk of Stroke Recurrence-A Systematic Review and Meta-Analysis. Stroke 2011; 42: 1489-1494.