Risk factors predisposing to stroke recurrence within one year of non-cardioembolic stroke onset: The Fukuoka Stroke Registry

Background: Recurrent strokes occur more frequently during the first year after an ischemic stroke. We investigated the relationship between patient clinical characteristics and stroke recurrence according to the non-cardioembolic type of ischemic stroke, and determined the predisposing factors associated with a recurrence within the first year. Methods: From June 2007 to December 2008, 1,106 consecutive ischemic stroke patients who were hospitalized in the 7 FSR stroke centers within 7 days after the onset of their stroke were enrolled in this study. We assessed the clinical characteristics of the patients on admission, and followed their clinical courses for one year. Results: Of all patients, 876 (537 males and 339 females, 70 ± 12 years of age) who had suffered from a non-cardioembolic stroke were investigated. Seventy-one patients (8.1%) suffered from a recurrence of ischemic stroke during the follow-up period of one year. On multivariate Cox hazard regression analyses, age (HR 1.03, 95% CI 1.00-1.05, p = 0.030, per 1-year increase), high-density lipoprotein (HDL) cholesterol <40 mg/dl (HR 1.89, 95% CI 1.10-3.24, p = 0.021), and chronic kidney disease (CKD) (HR 1.73, 95% CI 1.03-2.90, p = 0.038) were independent predictors of a recurrence within one year after the non-cardioembolic stroke. Conclusions: In the patients demonstrating non-cardioembolic ischemic stroke, low HDL cholesterol levels and CKD in addition to aging were independent risk factors for a recurrence within one year after the onset.