Trends in Five-Year Survival and Risk of Recurrent Stroke after First-Ever Stroke in the Perth Community Stroke StudyHardie K.a · Jamrozik K.b · Hankey G.J.c, d · Broadhurst R.J.a · Anderson C.e
aSchool of Population Health, University of Western Australia, Perth, Australia; bImperial College of Science, Technology and Medicine, London, UK; cStroke Unit, Department of Neurology, Royal Perth Hospital, and dSchool of Medicine and Pharmacology, University of Western Australia, Perth, Australia; eClinical Trials Research Unit, University of Auckland, New Zealand
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Background: Few studies provide information on trends in the long-term outcome of stroke. Weaimed to determine trends in survival and recurrent stroke, over 5 years after first-ever stroke, for 2 cohorts of patients enrolled in the Perth Community Stroke Study in 1989–90 and 1995–96. Methods: For 12-month periods beginning February 1989 and February 1995, all individuals with an acute stroke who were resident in a geographically-defined and representative region of Perth, Western Australia, were registered and followed-up prospectively 5 years after the index event. Results: The 5-year cumulative risk of death was 59% (95% confidence interval (CI) 53%, 65%) and 58% (95% CI 52%, 65%) for the 1989–90 and 1995–96 cohorts, respectively (p = 0.94). The 5-year cumulative risk of first recurrent stroke was 32% (95% CI 25%, 40%) and 23% (95% CI 16%, 30%) for the 1989–90 and 1995–96 cohorts, respectively (p = 0.07). Conclusions: Although no statistically significant improvement occurred in 5-year survival after first-ever stroke in Perth between 1989–90 and 1995–96, there was a statistically nonsignificant trend towards a smaller cumulative risk of recurrent stroke over 5 years after a first-ever stroke. Serial community-based studies of the incidence and outcome of stroke are an important means of monitoring the translation of proven preventive interventions to improvements in population health.
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- Bonita R, Stewart A, Beaglehole R: International trends in stroke mortality: 1970–1985. Stroke 1990;21:989–992.
- McGovern PG, Burke GL, Sprafka JM, Xue S, Folsam AR, Blackburn H: Trends in mortality, morbidity and risk factor levels for stroke from 1960 through 1990. The Minnesota Heart Survey. J Am Med Assoc 1992;268:753–759.
- Wolf PA, D’Agostino RB, O’Neal MA, Sytkowski P, Kase CS, Belanger AJ, Kannel WB: Secular trends in stroke incidence and mortality: The Framingham Study. Stroke 1992;23:1551–1555.
- Brown RD Jr, Whisnant J, Sicks JD, O’Fallon WM, Wiebers DO: Stroke incidence, prevalence and survival: Secular trends in Rochester, Minnesota, through 1989. Stroke 1996;27:373–380.
- Thorvaldsen P, Kuulasmaa K, Rajakangas AM, Rastenyte D, Sarti C, Wilhelmsen L: Stroke trends in the WHO MONICA project. Stroke 1997;28:500–506.
Heart, Stroke and Vascular Diseases: Australian Facts 2001: National Centre for Monitoring Cardiovascular Disease. Australian Institute of Health and Welfare, Canberra, Australia (Catalogue No. CVD 13.), 2001.
- Harmsen P, Tsipogianni A, Wilhelmsen L: Stroke incidence rates were unchanged, while fatality rates declined, during 1971–87 in Goteburg, Sweden. Stroke 1992;23:1410–1415.
- Bonita R, Broad JB, Beaglehole R: Changes in stroke incidence and case-fatality in Auckland, New Zealand, 1981–91. Lancet 1993;342:1470–1473.
- Stegmayr B, Asplund K: Exploring the declining case fatality in acute stroke. Population-based observations in the northern Sweden MONICA Project. J Intern Med 1996;240:143–149.
- Ueda K, Omae T, Hirota YE: Decreasing trend in incidence and mortality from stroke in Hisayama residents, Japan. Stroke 1981;12:154–160.
- Tuomilehto J, Rastenyte D, Sivenius J: Ten-year trends in stroke incidence and mortality in the FINMONICA Stroke Study. Stroke 1996;27:825–832.
- Jamrozik K, Broadhurst RJ, Lai N, Hankey GJ, Burvill PW, Anderson CS: Trends in the incidence, severity, and short-term outcome of stroke in Perth, Western Australia. Stroke 1999;30:2105–2111.
- European Carotid Surgery Trialists’ Collaborative Group: Randomised trial of endarterectomy for recently symptomatic carotid stenosis: Final results of the MRC European Carotid Surgery Trial (ECST). Lancet 1998;351:1379–1387.
- Barnett HJM, Taylor DW, Eliasziw M, et al: for The North American Symptomatic Carotid Endarterectomy Trial Collaborators: Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. N Engl J Med 1998;339:1415–1425.
Antiplatelet Trialists’ Collaboration: Collaborative overview of randomised trials of antiplatelet therapy – I: Prevention of death, myocardial infarction and stroke by prolonged antiplatelet therapy in various categories of patients. Br Med J 1994;308:81–106.
- EAFT (European Atrial Fibrillation Trial) Study Group: Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 1993;342:1255–1262.
- Collins R, Peto R, MacMahon S, Herbert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO: Blood pressure, stroke and coronary heart disease. Part 2, short-term reductions in blood pressure: Overview of randomised drug trials in their epidemiological context. Lancet 1990;335:827–839.
- Bucher HC, Griffith LE, Guyatt GH: Effect of HMG CoA reductase inhibitors on stroke: A meta-analysis of randomised, controlled trials. Ann Intern Med 1998;128:89–95.
- The Long-term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group: Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998;339:1349–1357.
- Anderson CS, Jamrozik KD, Broadhurst RJ, Stewart-Wynne EG: Predicting survival for 1 year among different subtypes of stroke. Results from the Perth Community Stroke Study. Stroke 1994;25:1935–1944.
- Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Burvill PW, Anderson CS, Stewart-Wynne EG: Five-year survival after first-ever stroke and related prognostic factors in the Perth Community Stroke Study. Stroke 2000;31:2080–2086.
- Anderson CS, Jamrozik KD, Burvill PW, Chakera TM, Johnson GA, Stewart-Wynne EG: Ascertaining the true incidence of stroke: Experience from the Perth Community Stroke Study, 1989–1990. Med J Aust 1993;158:80–84.
- Ward GR, Jamrozik K, Stewart-Wynne E: Incidence and outcome of cerebrovascular disease in Western Australia. Stroke 1988;19:1501–1506.
- Hatano S: Experience from a multicentre stroke register: A preliminary report. Bull World Health Organ 1976;54:541–553.
- Scmidt EV, Smirnov VE, Ryabova VS: Results of the seven-year prospective study of stroke patients. Stroke 1988;19:942–949.
Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C: Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project. Stroke 1994;25:333–337.
- Dennis MS, Burn JP, Sandercock PA, Bamford JM, Wade DT, Warlow CP: Long-term survival after first-ever stroke: The Oxfordshire Community Stroke Project. Stroke 1993;24:796–800.
Deaths, Australia. Australian Bureau of Statistics. ABS Catalogue No. 3302.0: Canberra, Australia, 1998.
Statistical Analysis System Institute Inc. SAS Version 6.0. Cary, NC:SAS Inc., 1991.
Sackett DL, Haynes RB, Guyatt GH, Tugwell MD: Clinical epidemiology: A basic science for clinical medicine. ed 2. Boston, Little, Brown, 1991:173–185.
- Terent A: Trends in Stroke Incidence and 10-Year Survival in Soderhamn, Sweden, 1975–2001. Stroke 2003;34:1353–1358.
- Meissner I, Whisnant JP, Garraway WM: Hypertension management and stroke recurrence in a community (Rochester, Minnesota, 1950–1979). Stroke 1988;19:459–463.
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