Recurrent ischemic stroke in young adults: A multicenter cohort study, systematic review, and meta-analysis

作者：Gabriel Yi Ren Kwok, R. Chen, Tjun Wei Leow, Charlene Kok, Nicole Yeong, Yao Hao Teo, Chen Ee Low, Sarah Wright, John Fink, Vijay K. Sharma, Hock Luen Teoh, Poay Huan Loh, Ching‐Hui Sia, Leonard L.L. Yeo, Aftab Ahmad, Teddy Y. Wu, Benjamin Kye Jyn Tan, Benjamin KJ Tan, Benjamin YQ Tan, Benjamin YQ Tan · 发表于：International Journal of Stroke · 年份：2025 · DOI：10.1177/17474930251340799 · 被引用次数：8 · 研究领域：Acute Ischemic Stroke Management、Blood Coagulation and Thrombosis Mechanisms、Cerebrovascular and Carotid Artery Diseases

BACKGROUND: Recurrent ischemic stroke (IS) disproportionately affects individuals in their most productive years, contributing to significant morbidity and mortality. Despite its growing importance, data on this critical population remain limited. AIM: The aim of the study is to characterize rates and factors associated with recurrent IS in young adults. METHODS: We performed a retrospective multicentre cohort study of consecutive acute IS patients aged 18-50 years from three tertiary hospitals in Singapore and Christchurch, New Zealand. We characterized rates and prognostic factors associated with recurrent IS over 1-year follow-up using univariate and multivariable Cox Proportional Hazards models. We then performed a systematic review and meta-analysis of PubMed, Embase, Scopus and Cochrane databases for all studies from January 2000 to July 2024 evaluating recurrent stroke or transient ischemic attack (TIA) following an index IS or TIA. We meta-analyzed rates and factors associated with recurrent cerebrovascular events based on aggregate count, aggregate survival, and individual patient-level survival data reconstructed from Kaplan-Meier curves. RESULTS: The cohort study of 845 patients showed a 3.41% (95% confidence interval (CI) = 2.16-4.64) recurrence rate over 1-year follow-up. Patients with diabetes mellitus and prior stroke/TIA had significantly higher rates of recurrent IS. The systematic review and meta-analysis of 18,955 patients across 31 studies yielded a recurr...