Article Figures & Data
- Figure 1
Flow diagram of participants in this study. CNSR, China National Stroke Registry; ICH, intracerebral haemorrhage; IS, ischaemic stroke; SAH, subarachnoid haemorrhage; TIA, transient ischaemic attack.
- Figure 2
One-year outcomes after ischaemic stroke or TIA at different time period (2007–2008, 2012–2013 and 2015–2018). MI, myocardial infarction; TIA, transient ischaemic attack.
- Figure 3
Cumulative incidence of 1-year MI or vascular death between different subgroup in 2015–2018 cohort. CAD, coronary artery disease; MI, myocardial infarction; TIA, transient ischaemic attack; TOAST, Trial of Org 10 712 in acute stroke treatment.
- Table 1
Baseline characteristics and outcomes of three time period cohorts
CNSR-I
2007–2008
(n=13 616)CNSR-II
2012–2013
(n=21 952)CNSR-III
2015–2018
(n=15 166)P for trend* Demographics Age, median (IQR), y 67 (56–74) 65 (56–74) 63 (54–70) 0.990 Ethnicity (non-Han) 460 (3.4) 669 (3.1) 440 (2.9) 0.066 Female sex 5235 (38.5) 7949 (36.8) 4802 (31.7) <0.001 Medical history Previous stroke/TIA 4263 (31.3) 7711 (35.7) 3675 (24.2) <0.001 CHD/previous MI 1961 (14.4) 2920 (13.5) 1608 (10.6) <0.001 Hypertension 8484 (62.3) 13 861 (64.2) 9494 (62.6) <0.001 Diabetes mellitus 2831 (20.8) 4403 (20.4) 3510 (23.1) <0.001 Dyslipidaemia 1552 (11.4) 2656 (12.3) 1191 (7.9) <0.001 Atrial fibrillation 960 (7.1) 1467 (6.8) 1019 (6.7) 0.505 Onset-to-door time, median (IQR), h 11.3 (2.9–39.0) 21.0 (5.0–52.6) 11.8 (3.1–32.6) 0.993 NIHSS at admission, median (IQR) 4 (2–9) 3 (1–6) 3 (1–6) 0.972 In-hospital outcomes mRS ≤2 at discharge 9508 (70.0) 16 647 (77.2) 12 464 (82.4) <0.001 In-hospital mortality 355 (2.6) 223 (1.0) 35 (0.2) <0.001 1 year outcomes MI or vascular death 1518 (11.2) 1565 (7.3) 251 (1.7) <0.001 MI or non-stroke vascular death 451 (3.3) 582 (2.7) 104 (0.7) <0.001 MI or all-cause death 1870 (13.7) 1945 (9.0) 563 (3.7) <0.001 Recurrent Stroke 2302 (17.8) 1573 (7.3) 1473 (9.7) <0.001 Vascular death 1378 (10.1) 1303 (6.0) 222 (1.5) <0.001 MI 180 (1.3) 298 (1.4) 39 (0.3) <0.001 Values are presented as n (%) unless otherwise indicated.
*Based on ANOVA.
ANOVA, analysis of variance; CHD, coronary heart disease; CNSR, China National Stroke Registry; MI, myocardial infarction; mRS, modified Rankin scale; NIHSS, National Institutes of Health Stroke Scale; TIA, transient ischaemic attack.
- Table 2
Baseline characteristics and outcomes of 26 hospitals included in all three cohorts
CNSR-I
2007–2008
(n=3015)CNSR-II
2012–2013
(n=1984)CNSR-III
2015–2018
(n=1750)P for trend* Demographics Age, median (IQR), y 65 (55–73) 64 (55–73) 62 (54–69) 0.990 Ethnicity (non-Han) 149 (4.94) 99 (4.99) 53 (3.03) 0.004 Female sex 1080 (35.8) 687 (34.6) 504 (28.8) <0.001 In-hospital outcomes mRS ≤2 at discharge 2164 (71.9) 1533 (77.3) 1247 (71.3) 0.745 In-hospital mortality 68 (2.3) 22 (1.1) 2 (0.1) <0.001 1 year outcomes MI or vascular death 348 (11.5) 129 (6.50) 15 (0.9) <0.001 MI or non-stroke vascular death 100 (3.3) 54 (2.72) 8 (0.5) <0.001 MI or all-cause death 409 (13.6) 158 (8.0) 45 (2.6) <0.001 Recurrent stroke 544 (18.0) 132 (6.7) 171 (9.8) <0.001 Vascular death 307 (10.2) 95 (4.8) 11 (0.6) <0.001 MI 50 (1.7) 35 (1.8) 5 (0.3) <0.001 Values are presented as n (%) unless otherwise indicated.
*Based on ANOVA.
CNSR, China National Stroke Registry; MI, myocardial infarction; mRS, modified Rankin scale.
- Table 3
Predictors of 1-year MI or vascular death in 2015–2018 cohort
Predictor variable MI or vascular death Recurrent stroke Adjusted*
HR
(95% CI)P value Adjusted*
HR
(95% CI)P value Age, years 1.03 (1.02 to 1.04) <0.001 1.01 (1.00 to 1.01) <0.001 Male sex 0.89 (0.67 to 1.18) 0.405 1.06 (0.94 to 1.19) 0.381 NIHSS >6 1.91 (1.46 to 2.49) <0.001 1.21 (1.07 to 1.36) 0.002 Final diagnosis of stroke 2.51 (1.11 to 5.68) 0.028 2.20 (1.65 to 2.93) <0.001 TOAST Classification Cardioembolism 0.70 (0.43 to 1.14) 0.151 0.88 (0.68 to 1.13) 0.298 Non-cardioembolism Ref. Ref. Ref. Ref. Previous stroke/TIA 1.69 (1.30 to 2.20) <0.001 1.56 (1.40 to 1.75) <0.001 Previous MI 1.83 (0.96 to 3.47) 0.066 0.99 (0.69 to 1.42) 0.958 Coronary artery disease 1.50 (1.08 to 2.07) 0.015 1.23 (1.04 to 1.45) 0.016 Hypertension 0.95 (0.71 to 1.25) 0.695 1.01 (0.89 to 1.13) 0.937 Diabetes mellitus 1.15 (0.87 to 1.54) 0.332 1.17 (1.04 to 1.32) 0.008 Atrial fibrillation 1.83 (1.20 to 2.80) 0.005 1.14 (0.90 to 1.45) 0.272 Current smoking 0.96 (0.70 to 1.31) 0.799 1.01 (0.89 to 1.15) 0.863 Treatment Endovascular therapy 2.45 (1.13 to 5.33) 0.024 2.00 (1.21 to 3.29) 0.007 Early antiplatelet 0.47 (0.32 to 0.67) <0.001 0.70 (0.58 to 0.85) <0.001 Lipid lowing at discharge 0.39 (0.27 to 0.56) <0.001 0.70 (0.58 to 0.84) <0.001 Antihypertension at discharge 0.99 (0.74 to 1.31) 0.922 1.05 (0.93 to 1.17) 0.441 *Adjusted for sex, age, NIHSS >6, history of Previous stroke/TIA, previous MI, known coronary artery disease, hypertension, diabetes mellitus, atrial fibrillation, peripheral artery disease, current smoker and lipid lowering and antihypertensive treatments.
MI, myocardial infarction; NIHSS, National Institutes of Health Stroke Scale; TIA, transient ischaemic attack; TOAST, Trial of Org 10 712 in acute stroke treatment.
Supplementary Materials
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Supplementary Data
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