Article Figures & Data
Tables
- Table 1
Baseline characteristics of study cohort (n=3720)*
Demographic features (%) Age (years) 63±11 Male 65 Black race 12 Hispanic ethnicity 4 College education (>12 years) 48 Married/living with partner 71 Clinical history (%)† Stroke at entry (vs TIA) 87 Hypertension 72 Hyperlipidaemia 68 Coronary artery disease 12 Atrial fibrillation 7 Carotid artery disease 19 Peripheral vascular disease 6 Current smoker 16 Physical examination BMI (kg/m2) 30±6 Waist (cm) 103±14 Systolic blood pressure (mm Hg) 133±17 Diastolic blood pressure (mm Hg) 79±11 NIH Stroke Scale 0 (0,1) Modified Rankin 1 (0,2) Modified mini-mental examination 96 (92, 99) Laboratory data Haemoglobin A1c (%) 5.8±0.4 Homeostasis model assessment‡ 4.6 (3.7, 6.2) Low-density lipoprotein cholesterol (mmol/L) 2.3±0.8 High-density lipoprotein cholesterol (mmol/L) 1.2±0.3 Triglycerides (mmol/L) 1.6±0.8 Concomitant medications (%) Statin therapy 82 Aspirin 74 Non-ASA antiplatelet 43 Oral anticoagulants 11 Antithrombotics 99 Geography (%) USA 67 Canada 14 UK 7 Israel 5 Germany 4 *Plus–minus values are means±SD. Features are presented as median values (25th centile, 75th centile) when distributions are highly skewed.
†Clinical history variables were defined as follows: stroke versus TIA, see entry criteria; hypertension, self-report; hyperlipidaemia, self-report; coronary artery disease, self-report history of hospitalisation for myocardial infarction, coronary artery bypass graft or coronary stent insertion; atrial fibrillation, history as determined by site investigator; carotid artery disease, baseline carotid stenosis ≥50%; peripheral vascular disease, self-report; current smoking, self-report (uncertain self-report=‘no’).
‡HOMA is an index of insulin resistance based on fasting insulin and glucose values. HOMA >3.0 was used to identify patients with insulin resistance in IRIS.15
ASA, American Stroke Association; BMI, body mass index; HOMA, homeostasis model assessment; IRIS, Insulin Resistance Intervention after Stroke; TIA, transient ischemic attack.
- Table 2
Achievement of secondary stroke prevention goals by year in all countries combined
% Meeting physiological goals % Meeting drug use goals % Meeting behavioural goals Time point Pts alive % Meeting all goals % Meeting priority prevention goals* BP <140/90 mm Hg LDL-c <2.59 mmol/L BMI 18–25 kg/m2 Statin therapy Antithrombotic therapy† Cigarette smoking abstinence Safe alcohol use‡ Aerobic exercise§ Baseline 3720 3 47 66 70 18 83 99 84 93 48 Year 1 3639 4 49 70 68 17 79 97 84 94 48 Year 2 3543 4 51 71 70 18 80 97 84 95 46 Year 3 3255 4 52 72 70 18 78 96 84 95 47 *Priority prevention goals: BP <140/90 mm Hg, LDL-c <2.59 mmol/L and the use of antithrombotic therapy.
†Antithrombotic therapy includes antiplatelet or anticoagulation therapies.
‡Safe alcohol use defined as ≤2 drinks/day for males and ≤1 drink/day for females.24
§Aerobic exercise defined as large-muscle activities at least 3 days/week for a total of 20 min/day.34
BMI, body mass index; BP, blood pressure; LDL-c, low-density lipoprotein cholesterol; Pts, participants.
- Table 3
Achievement of priority prevention goals over time in all countries combined
Time period Baseline to year 1 Year 1 to year 2 Year 2 to year 3 Baseline to year 3 Preventive goal status* No. Per cent No. Per cent No. Per cent No. Per cent Stayed at goal 1008 32 1056 37 930 38 522 22 Stayed not at goal 1108 35 1011 36 812 34 463 19 Improved 552 17 410 14 342 14 754 32 Declined 522 16 366 13 338 14 636 27 Pts with data for time period 3190 2843 2422 2345 Stayed at goal or improved† 1560 49 1466 52 1272 53 1276 54 Goal status unknown‡ 438 686 818 895 Out of trial during period§ 92 99 289 480 *Preventive goal status defined as follows: stayed at goal, at goal in each year in period; stayed not at goal, not at goal in each year in period; improved, started period not at goal but at goal at end of year or in any year in period; declined, started period at goal but not at goal at end of year or in any year in period.
†Proportion of participants in trial and with data who stayed at goal or improved during period.
‡Data missing for at least one priority goal in any year in period.
§Dropped-out, died or exited during time period.
Pts, participants.
- Table 4
Achievement of priority prevention goals at baseline and year 3—overall and by country*
All Pts† Year 3 cohort‡ No. w/Data Baseline % No. w/Data Baseline % Year 3% All participants 3720 3667 47 3240 2529 48 52 USA 2592 2549 46 2246 1683 47 50 Canada 543 538 63 494 420 64 65 UK 256 253 42 211 175 43 53 Israel 178 178 37 166 147 37 45 Germany 151 149 39 123 104 38 38 χ2 p value <0.0001 <0.0001 <0.0001 *Priority prevention goals: BP <140/90 mm Hg, LDL-C <2.59 mmol/L and the use of antithrombotic therapy.
†Pts enrolled by country; w/Data=Pts not missing BP, LDL or medication use at baseline.
‡Pts in cohort at year 3 (excludes Pts who died or withdrew prior to year 3); w/Data=Pts with completed year 3 contact and not missing BP, LDL or medication use at baseline and year 3.
BP, blood pressure; LDL-c, low-density lipoprotein cholesterol; Pts, participants.
- Table 5
Baseline features associated with achievement of priority prevention goals from baseline to year 3*
Bivariate analysis Adjusted analysis† Feature present Feature not present Baseline feature Pts At goal Pts At goal OR‡ p Value OR p Value Male sex 678 56% 307 46% 1.54 0.002 1.40 0.02 White race 846 56% 131 36% 2.26 <0.0001 1.71 0.01 Married/with partner 738 57% 244 42% 1.79 <0.0001 1.47 0.02 Non-smoker 844 55% 141 42% 1.69 0.004 1.62 0.01 3MS score, mean (SD) 95.6 (5.0)§ 94.0 (6.7)↵ 1.61 <0.0001 1.55 0.0003 *Priority prevention goals: BP <140/90 mm Hg, LDL-c <2.59 mmol/L and the use of antithrombotic therapy. Comparison group is participants not at goal at any time from baseline to year 3.
†Logistic model selected in stepwise procedure considering only significant features in bivariate analysis.
‡OR for being at goal if feature present versus absent for categorical features; OR for 10 unit change in 3MS score.
§Mean + SD for patients at goal.
↵Mean + SD for patients not at goal.
3MS, modified mini-mental state; BP, blood pressure; LDL-c, low-density lipoprotein cholesterol; Pts, participants.
Supplementary Materials
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