Variations in Risk Factors across Different Periods of Stroke Recurrence

Background and Purpose Accurately discerning periods of heightened risk of stroke recurrence and managing modifiable risk factors are essential for minimizing overall recurrence risk. This study identified differences in the timing of stroke recurrence based on risk factors and patient characteristics to develop strategies for reducing recurrence in clinical practice. Methods We retrospectively selected patients with ischemic stroke or transient ischemic attack at the Korea University Ansan Hospital Stroke Center between March 2014 and December 2021 using the prospective institutional database of the Korea University Stroke Registry. We collected demographic, clinical, and stroke data and categorized participants by recurrence timing (early within 3 months or late after 3 months). Using multinomial logistic regression analysis, we examined variables associated with early and late recurrent strokes. Results The analysis included 3,646 patients, of whom 255 experienced a recurrent stroke and 3,391 experienced their first stroke. Multinomial logistic regression analysis revealed significant associations between early recurrent stroke and diabetes mellitus (OR 1.98, 95% CI 1.25–3.15), other determined etiologies in TOAST classification (OR 3.00, 95% CI 1.37– 6.61), and white matter changes (OR 1.97, 95% CI 1.17–3.33). Late recurrent stroke showed a significant correlation with transient ischemic attack (TIA) (OR 2.95, 95% CI 1.52–5.71) and cerebral microbleeds (OR 2.22, 95% CI 1.32–3.75). Conclusion Our study emphasizes substantial differences in factors contributing to stroke recurrence based on timing. Managing the risk of recurrence in clinical practice necessitates accurate identification of heightened risk periods and rigorous control of modifiable risk factors.