Very long-term mortality after ischemic stroke: predictors of cardiovascular death.

BACKGROUND: The purpose of this article is to find possible predictors associated with long-term mortality and long-term cardiovascular death after stroke.

METHODS: A cohort of 550 patients with acute stroke admitted to a single hospital within 24 h of a stroke were recruited consecutively. Patients were followed for 12 years or until death. Information on death was collected through linkage with the National Population Register of Statistics Norway, an official register containing name, date of birth, address, and date of death, and the National Register of Cause of Death. Cardiovascular deaths were defined as ICD 9 codes 390 to 448 and ICD 10 codes I00 to I99.

RESULTS: The proportion of cardiovascular deaths was 71%. In multivariate Cox regression analysis of cardiovascular mortality, stroke severity (HR 2.78; 95% CI 2.13-3.57), hemorrhagic stroke (2.0; 1.43-2.78), diabetes (1.85; 1.37-2.50), male gender (1.69; 1.31-2.17), ischemic heart disease (1.56; 1.16-2.13), age (1.06; 1.04-1.08), and right hemispheric stroke (1.49; 1.16-1.89) were significant predictors.

DISCUSSION: This study shows that age, male gender, stroke severity, hemorrhagic stroke, diabetes, ischemic heart disease, and right hemispheric stroke are predictors associated with increased risk of long-term cardiovascular mortality. Neither atrial fibrillation, antihypertensive treatment on admission, smoking, or living alone was risk factors for late cardiovascular deaths.