Table 2.
Predictive factors for recurrent ischemic stroke
| Predictive factor | Study | Sample size,n | Variable definition | Factor prevalence, % | Follow-up duration | uvRR (95% CI) | mv HR (95% CI) |
|---|---|---|---|---|---|---|---|
|
Clinical factors Strong level |
|||||||
| Prior stroke/TIA | Ay et al. [23], 2010 | 1,458 | – | 8 | 90 days | 3.4 (2.1–5.6) | |
| I 2 = 0% | Bergströmet al. [4], 2017 | 196,765 | Prior ischemic stroke | 15 | 1 year | 1.3 (1.2–1.4) | |
| Kim et al. [24], 2014 | 2,378 | Within last month | 14 | 90 days | 2.6 (1.9–3.4) | ||
| Kuwashiro et al. [25], 2012 | 260 | Prior ischemic stroke | 24 | 12 months | 1.8 (1.1–3.1) | OR 2.0 (0.8–5.0) | |
| Soda et al. [28], 2004 | 713 | Prior stroke/TIA | 27 | 12 months | 2.3 (1.5–3.8) | ||
| Pooled | 2.5 (2.1–3.1) | ||||||
| Small vessel disease vs. LAA | Ay et al. [23], 2010 | 1,458 | CCS | 10 | 90 days | 0.1 (0.0–0.7) | |
| I 2 = 67% | Kim et al. [24], 2014 | 2,378 | CCS | 12 | 90 days | 0.1 (0.0–0.3) | |
| Kuwashiro et al. [25], 2012 | 260 | TOAST | 31 | 12 months | 0.3 (0.1–0.9) | ||
| Nam et al. [27], 2017 | 959 | TOAST | 31 | 31 months | 0.5 (0.3–1.0) | ||
| Soda et al. [28], 2004 | 745 | NINDS | 26 | 12 months | 0.8 (0.4–1.7) | ||
| Pooled | 0.3 (0.1–0.7) | ||||||
| Moderate level | |||||||
| Undetermined cause vs. LAA | Ay et al. [23], 2010 | 1,458 | CCS | 36 | 90 days | 0.4 (0.2–0.7) | |
| = 76% | Kim et al. [24], 2014 | 2,378 | CCS | 12 | 90 days | 0.2 (0.1–0.5) | |
| Soda et al. [28], 2004 | 745 | NINDS: uncertain cause | 22 | 12 months | 1.1 (0.5–2.2) | ||
| Pooled | 0.5 (0.2–1.1) | ||||||
| Imaging factors (MRI) Moderate level | |||||||
| Multiple lesions | Ay et al. [23], 2010 | 1,458 | * | 40 | 90 days | 1.8 (1.5–2.1) | |
| I 2 = 0% | Nam et al. [27], 2017 | 959 | * | 39 | 31 months | 1.6 (1.3–2.0) | |
| Pooled | 1.7 (1.5–2.0) | ||||||
| Multiple stage lesions | Ay et al. [23], 2010 | 1,458 | * | 11 | 90 days | 3.5 (2.4–5.2) | |
| I 2 = 13% | Nam et al. [27], 2017 | 959 | * | 11 | 31 months | 4.7 (3.3–6.7) | 6.0 (3.5–10.1) |
| Pooled | 4.1 (3.1–5.5) | ||||||
| Multiple territory lesions | Ay et al. [23], 2010 | 1,458 | * | 10 | 90 days | 2.7 (1.7–4.4) | |
| I 2 = 0% | Nam et al. [27], 2017 | 959 | * | 6 | 31 months | 3.2 (1.8–5.8) | |
| Pooled | 2.9 (2.0–4.2) | ||||||
| Chronic infarcts | Ay et al. [23], 2010 | 1,458 | * | 30 | 90 days | 1.4 (1.1–2.0) | |
| I 2 = 0% | Kim et al. [24], 2014 | 2,378 | * | 15 | 90 days | 1.6 (1.1–2.3) | 1.4 (0.9–2.3) |
| Pooled | 1.5 (1.2–1.9) | ||||||
| Isolated cortical lesion | Ay et al. [23], 2010 | 1,458 | * | 9 | 90 days | 2.2 (1.3–3.8) | |
| I 2 = 0% | Nam et al. [27], 2017 | 959 | * | 9 | 31 months | 2.1 (1.2–3.8) | 2.5 (1.3–5.0) |
| Pooled | 2.2 (1.5–3.2) | ||||||
| Limited level | |||||||
| White matter lesions | Kim et al. [24], 2014 | 2,378 | * | 44 | 90 days | 1.2 (1.0–1.5) | 1.5 (1.0–2.3) |
| I 2 = 79% | Nam et al. [27], 2017 | 959 | * | 25 | 31 months | 2.0 (1.5–2.7) | 1.9 (1.1–3.4) |
| Pooled | 1.5 (0.9–2.6) | ||||||
*
Online supplementary Table III for definitions of imaging factors.
Pooled values in bold. uv, univariable; RR, risk ratio; mv, multivariable; HR, hazard ratio; TIA, transient ischemic attack; LAA, large artery atherosclerosis; CCS, Causative Classification System for ischemic stroke; TOAST, Trial of ORG 10172 in Acute Stroke Treatment; NINDS, National Institute of Neurological Diseases and Stroke.