Analysis Of The Risk Factors Of Cerebral Infarction Recurrence

Objective:To explore the risk factors of recurrent cerebral infarction, to analysis the proportion of recurrent cerebral infarction subtypes according to the TOAST criteria.Methods:Data were collected prospectively from 371 consecutive ischemic stroke inpatients in our department from April 2009 toJanuary 2010. After completing medical records and auxiliary diagnostic studies, all included patients were classified into 5 major ischemic stroke subtypes based on TOAST criteria.Results:①In the 183 cases once cerebral infarction patients, male patients are 116 cases, and the mean age is 61.73±8.71 years old. In the 188 cases recurrent cerebral infarction patients, male patients are 118 cases, and mean age is 65.92±9.44 years old. There are statistic differences between ages (P<0.05).②The level of hypertension,atrial fibrillation,hypercholesterolemia,unstable plaques,smoking,age,low density lipoprotein and homocysteine in the recurrent group are significantly higher than those in the once ischemic stroke group(P< 0.05).③non-conditional Logistic regression shows that hypertension (OR=2.879 ,95%CI (1.510-1.750),P= 0.039),atrial fibrillation (OR=2.689,95%CI (1.195-2.035), P=0.029),hypercholesterolemia (OR=2.207,95%CI(1.156-4.214),P=0.016),age (OR=1.025, 95%CI (1.001-1.049), P=0.040),homocysteine (OR=1.026,95%CI (1.003-1.050),P= 0.029)are the independent risk factors of the cerebral infarction recurrence.④The proportion of ischemic stroke subtype according to TOAST criteria is as follows:large-artery atherosclerosis(LAA)14.3% cardioembolism(CE)14.3%, small-artery occlusion lacunar(SAA)27.1%, stroke of other demonstrated etiology(SOE)3.2%, stroke of undetermined etiology (SUE) 35.1%. The proportions of hypertension and hypercholesterolemia have statistic differences among the 5 groups (P<0.05). The highest proportions of hypertention and hypercholesterolemia are seen in stroke of undetermined etiology (SUE) patients compared to the others.And the highest total cholesterol and low density lipoprotein levels are seen in LAA patients.There are statistic differences among the 5 groups (P<0.05).Conclusion:①Hypertension,atrial fibrillation,hypercholesterolemia,age and homocysteine are the independent risk factors of the cerebral infarction recurrence.②In the comparison among the 5 groups, the highest proportions of hypertension and hypercholesterolemia are seen in SUE patients. Hypertension and hypercholesterolemia may play more important roles in the recurrence of SUE.③The highest total cholesterol and low density lipoprotein levels are seen in LAA patients of cerebral infarction recurrence. Total cholesterol and low density lipoprotein may play more important roles in the recurrence of LAA.