Background/Aims: The risk of stroke recurrence and mortality varies across subgroups of ischemic stroke or transient ischemic attack (TIA) patients, with current research primarily focused on short-term follow-up. We aimed to identify risk factors associated with stroke recurrence or death in this population.
Methods: Participants were consecutive survivors of stroke or TIA between 2017 and 2023 in a single center, Thailand. Baseline characteristics, brain imaging and stroke subtypes were assessed. Cox proportional hazards models were used to identify risk for recurrent stroke/death.
Results: A total of 1365 patients were enrolled. The median follow-up was 551 days (Interquartile range, 181 to 1238). One hundred and ninety-eight patients (14.5%) experienced recurrent stroke/death. Probability of stroke recurrence or death at 1-year and 5-years were at 15.8% and 35.4% respectively. Risk of recurrence stroke or death associated with initial NIHSS score > 15 points (HR 2.17; 95% CI 1.44 – 3.26; p = 0.001), pre-existing ischemic heart disease (HR 1.97; 95% CI 1.42-2.7.3; p< 0.001) and small vessel occlusion stroke (HR 1.59; 95% CI 1.09 – 2.32; p < 0.001).
Conclusion: This study highlights the growing risk of stroke recurrence/death in Thai ischemic stroke/TIA patients. Identifying patients with high NIHSS scores, ischemic heart disease, or small vessel occlusion is crucial for risk stratification and targeted prevention strategies.