Neurology: Effects of vascular disease on long-term risk of recurrence after TIA or stroke

The purpose of this study was to determine whether patients with TIA or ischemic stroke had a high risk of relapsing ischemic events, despite current secondary prevention guidelines, where they had a history of cardiovascular disease (i.ecoronary heart disease or peripheral artery disease)in a population-based study in Oxfordshire, England, we studied patients with TIA or ischemic stroke who were continuously admitted from 2002 to 2014Patients were treated according to the current secondary prevention guidelines, and we determined the risk of coronary artery events, recurrent ischemic stroke and haemorrhage, and stratified according to the presence of co-existing cardiovascular diseasesresults, in 2,555 patients (9,148 patients with annual follow-up time), patients with cardiovascular disease (n s 640; 25.0%) (449 coronary arteries; 103 Only peripheral blood vessels; 88 have) a higher risk of 10-year coronary artery event than patients without coronary artery events (22.8%, 95% confidence interval 17.4-27.9; vs 7.1%, 53-8.8; p 0.001; age and gender-corrected risk ratio s.07, 2.24-4.21) and recurrent ischemic stroke (31.5%, 25.1-37.4; vs23.4%, 20.5-26.2; p s 0.0049; age and gender-corrected HR 1.23, 0.99-1.53), although the use of anti-thrombosis and blood lipid-lowering drugs was similarHowever, in non-myocardial TIA/stroke patients, patients with concurrent cardiovascular disease also have a higher risk of extracranial bleeding, especially those aged 75 (88-13.0; vs 3.4%, 1.6-5.3; p s 0.0050; age and gender-corrected HR 2.71, 1.16-6.30), although the risk of cerebral hemorrhage did not increase (age and gender correction HR 0.36, 0.04-2.99)in general, as in previous studies, patients with cardiovascular disease with TIA/stroke, although the current management method is still treated, the risk of relapsing ischemic events remains highTherefore, enhanced blood lipid reduction therapy may be reasonable, but the benefits of increased antithrombotic therapy may be offset by a high risk of extracranial bleeding