Abstract 5825: Comparison of Cardiovascular Risk Factors and Survival in 99608 Patients With Ischemic or Hemorrhagic Stroke
Aim: To compare relations between cardiovascular risk factors (CVD) and survival after stroke among 99608 patients by stroke subtype (ischemic (IS) or hemorrhagic stroke (HS)).
Background: Few studies have been able to provide information on large cohorts where risk factors associated with IS and HS can be compared. The Swedish Stroke Register (Riks-Stroke) has a 83% national coverage of all hospitalised strokes in Sweden and is thus one of the largest available stroke data bases of a general population.
Method: A cohort of 87 111 (83%) IS and 12497 (12%) HS patients were identified in the register between 2001–2005 and data on sex, age, and CVD risk factors were collected. All patients were followed up through record linkages to the Swedish Hospital Discharge and Cause of Deaths registers for 6.1 years (2.4 yrs mean follow up). Adjusted odds and hazard ratios (OR, HR) and 95% Confidence Interval (CI) were calculated using logistic and Cox proportional hazard regression models.
Results: Mean age (SD) was 73.5 (11.2) for IS men and 78.1 (11.2) for women; corresponding numbers for HS was 70.2 (12.6) for men and 75.4 (12.6) for women. A weak but significant association was found among women for IS vs. HS (OR=1.06, 1.02–1.10). Increased ORs for IS compared with HS was associated with all risk factors studied:1.82 (1.73–1.91) for atrial fibrillation, 1.57 (1.47–1.67) for congestive heart failure, 1.57 (1.47–1.67) for smoking, 1.49 (1.41–1.56) for diabetes, 1.12 (1.08 –1.17) for hypertension, and 1.09 (1.04 –1.14) for having had a previous stroke. Death within 30 days after stroke was strongly associated with HS compared with IS (HR=3.60, 3.46 –3.76). This increased risk was markedly attenuated after 30 days through end of follow-up (HR=1.17, 1.12–1.22).
Conclusions: HS patients were significantly younger than IS patients. Women were approximately 5 years older ans had a slightly higher frequency of IS. All CVD risk factor studied were associated with increased ORs for IS as compared to HS. However, mortality rates were higher among HS (vs IS) patients. The major part of this increment was explained by higher 30-day case fatality among HS patients.