smoking and stroke recurrence

Chronic alcoholism and heavy drinking are risk factors for stroke. Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture, Subarachnoid and intracerebral hemorrhage: natural history, prognosis, and precursive factors in the Framingham Study, Postmenopausal estrogen and prevention bias, Early assessment of China's 2015 tobacco tax increase, Journal of the American Heart Association, Impact of Smoking Status on Stroke Recurrence, Change in Life’s Simple 7 Measure of Cardiovascular Health After Incident Stroke, Trends in Active Cigarette Smoking Among Stroke Survivors in the United States, 1999 to 2018, Creative Commons Attribution‐NonCommercial, Copyright © 2019 The Authors. use prohibited. -, Kawachi I, Colditz GA, Stampfer MJ, Willett WC, Manson JE, Rosner B, Speizer FE, Hennekens CH. Persistent smokers were younger (56.5±11.2 versus 58.5±10.9, P<0.001), were less likely to have a high National Institutes of the Health Stroke Scale score on admission (eg, National Institutes of the Health Stroke Scale >14, 0.8% versus 10.5%, P<0.001), and had a lower proportion of atrial fibrillation than quitters (3.7% versus 6.1%, P=0.047, Table S2). Of the 3069 enrolled patients, 1331 (43.4%) were nonsmokers, 263 (8.6%) were former smokers, and 1475 (48.0%) were current smokers. The association between smoking and the risk of stroke recurrence was analyzed with multivariate Cox regression model. At one-year, the risk of stroke recurrence was 5.1% in these patients. The association between smoking and the risk of stroke recurrence was analyzed with multivariate Cox regression model. Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi'an stroke registry study of China. Smokers who did not meet the criterion of former smokers were classified as current smokers. Considering the significant impact of smoking on risk of stroke and many other chronic diseases, more active policies, such as subsidization for nicotine replacement therapy, should be implemented. At baseline, among 3069 patients included, 1331 (43.4%) were nonsmokers, 263 (8.6%) were former smokers, and 1475 (48.0%) were current smokers. Definitions for use in a multicenter clinical trial, Stroke—1989 recommendations on stroke prevention, diagnosis, and therapy. Patients who died, were lost to follow‐up, or experienced a recurrent nonfatal stroke within the first 3 months were excluded from data analysis (Figure S1). Recurrent strokes were observed in 206 patients during the 1-year follow-up period, and 683 deaths occurred before any recurrence. The main items of the survey included smoking history, smoking intensity (average cigarettes consumed per day), smoking duration (years of smoking), smoking cessation, and cessation time. Each year, nearly 200,000 strokes in the U.S. are a second (third, fourth) stroke. The follow‐up started at 3 months after the index stroke, and it extended to the date of the first recurrent fatal or nonfatal stroke, or censoring. Current smokers were younger (57.7±11.1 versus 60.6±12.1, P<0.001), had a lower prevalence of hypertension (69.2% versus 74.5%, P=0.002), atrial fibrillation (5.2% versus 9.7%, P<0.001), and coronary heart diseases (5.2% versus 7.7%, P=0.008) than nonsmokers. Rates, predictors, and outcomes of early and late recurrence after stroke: the North Dublin Population Stroke Study, Recurrence after ischemic stroke in Chinese patients: impact of uncontrolled modifiable risk factors, Baseline smoking status and the long‐term risk of death or nonfatal vascular event in people with stroke: a 10‐year survival analysis, Long‐term survival and vascular event risk after transient ischaemic attack or minor ischaemic stroke: a cohort study, Association of hypertension with stroke recurrence depends on ischemic stroke subtype, Subtypes and one‐year survival of first‐ever stroke in Chinese patients: the Nanjing Stroke Registry, Effect of smoking cessation on multiple sclerosis prognosis, Joint effects of smoking and sedentary lifestyle on lung function in African Americans: the Jackson Heart Study Cohort, Cigarette smoking and chronic kidney disease in African Americans in the Jackson Heart Study, Measurements of acute cerebral infarction: a clinical examination scale, Classification of subtype of acute ischemic stroke. Change in Life's Simple 7 Measure of Cardiovascular Health After Incident Stroke: The REGARDS Study. Detailed information about NSRP has been published previously.14 The study was approved by the Ethics Review Board of Jinling Hospital. At the first follow‐up, 908 (61.6%) patients quit smoking. Privacy, Help In this study, stroke was defined as a clot disrupting blood flow to the brain or bleeding in the brain (hemorrhagic). After a mean follow-up of 2.4±1.2 years, 293 (9.5%) patients had stroke … 45%-65% of strokes occur within 30 days of a TIA ! bAdjusted for these variables in those cases without missing values. By continuing to browse this site you are agreeing to our use of cookies. Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB), Journal of the American Heart Association (JAHA), Basic, Translational, and Clinical Research, Journal of the American Heart Association. The risk of recurrence 1 year after initial attack is 8.0% ! Frequent Premature Atrial Contractions as a Poor Prognostic Factor in Cryptogenic Stroke Patients with Concomitant Non-Sustained Atrial Tachycardia. Theoretically, former smokers have an intermediate risk of stroke,3 but they were usually assigned as either smokers5, 6 or nonsmokers.7 A large proportion of smokers may quit smoking after stroke, but they were usually defined as persistent smokers according to baseline assessments.8, 9 In this circumstance, the effects of smoking cessation after stroke, therefore, were neglected. Methods: Included in the series were 689 patients with NIHSS lower than 4 at hospital admission. Among them, the results indicated that age, family history of stroke, smoking status, diabetes mellitus, peripheral artery disease, hypercoagulable state, depression, and NIHSS score status were significant associated with recurrent stroke. FOIA The effect of smoking cessation on stroke has been studied in previous studies.1, 2, 3 The risk of stroke decreases after 2 to 4 years of smoking cessation and returns to the level of nonsmokers by 5 years of smoking cessation.1, 2 Smoking increases the risk of stroke in the short term by promoting thrombosis21 and reducing cerebral blood flow via arterial vasoconstriction.22 The thrombotic process can be reversible,23 and cerebral blood flow can have a significant improvement soon after quitting.22 Previous studies have reported that the smoking cessation rate was 40% to 94% at 1 year24, 25 and 37% at 5 years26 after the first stroke. The risk of stroke recurrence did not appear to be related to age or pathological type of stroke. -. BMI indicates body mass index; CHD, coronary heart diseases; NIHSS, National Institutes of Health Stroke Scale; TIA, transient ischemic attack. People who smoke are twice at risk of an ischemic stroke – caused by a blood clot that blocks the blood vessels – than those who do not smoke. In multivariate analysis, recurrence was more frequently associated with a history of TIA, atrial fibrillation, male gender, and hypertension, but not with age, daily alcohol consumption, smoking, diabetes, ischemic heart disease, serum cholesterol, or hematocrit. 1-800-AHA-USA-1 Among these, we excluded 128 patients who were lost to follow‐up, 39 patients who died, and 27 patients who experienced a nonfatal stroke within the first 3 months. 2020 Jun 1;3(6):e204813. JAMA Netw Open. The American Heart Association is qualified 501(c)(3) tax-exempt The primary end point was defined as fatal or nonfatal recurrent stroke after 3 months of the index stroke. Stroke. At baseline, among 3069 patients included, 1331 (43.4%) were nonsmokers, 263 (8.6%) were former smokers, and 1475 (48.0%) were current smokers. “We thought former smokers would have an intermediate risk of aneurysm recurrence, when in fact they didn’t,” Thompson says. The cumulative amount of smoking was measured in pack‐years, which was calculated by the average number of packs per day and years of smoking. Categorical variables were compared with χ2 test and continuous variables with Mann–Whitney U test or Student t test as appropriate. However, smoking cessation was no longer associated with a reduction both in risk of total stroke recurrence (HR, 0.78; 95% CI, 0.54–1.12) and in risk of ischemic stroke recurrence (HR, 0.76; 0.52–1.10, Table 3). Among persistent smokers, hazard ratios for stroke recurrence ranged from 1.68 (95% CI, 1.14–2.48) in those who smoked 1 to 20 cigarettes daily to 2.72 (95% CI, 1.36–5.43) in those who smoked more than 40 cigarettes daily (P for trend <0.001). Keywords: Local Info Customer Service 2020 Oct 20;20(1):379. doi: 10.1186/s12883-020-01954-3. Those who quit for a time and resumed smoking and those who quit for <1 month were categorized as persistent smokers. Smoking is a major cause of cardiovascular disease (CVD) and causes one of every four deaths from CVD. Alcoholism … doi: 10.1371/journal.pone.0231987. Modifiable fac - tors include hypertension, hyperlipidemia, diabetes, and lifestyle factors. This site needs JavaScript to work properly. These results highlight the importance of smoking cessation for secondary stroke prevention. Clinical manifestations, neuroimaging results, medical records, death certificates, and other available data were used to determine stroke recurrence. Risk factors predisposing to stroke recurrence within one year of non‐cardioembolic stroke onset: the Fukuoka Stroke Registry. The risk of recurrence is 30%-40% within the first 5 years after original infarct ! The distribution pattern of continuous variables was checked by Kolmogorov–Smirnov test. Risk factors for stroke included modifiable factors such as hypertension, cardiovascular disease, hypercholesterolemia, obesity, diabetes mellitus, smoking habit, alcohol abuse, stroke history, and use of contraceptive pills; and non-modifiable factors such as age, sex, ethnicity, and genetics. Patients were evaluated at follow-up for clinical events, medical treatment, and main risk factors (smoking status, blood pressure, and lipid profile). At baseline, among 3069 patients included, 1331 (43.4%) were nonsmokers, 263 (8.6%) were former smokers, and 1475 (48.0%) were current smokers. The ≈7 million adult stroke survivors in the United States remain at high risk for a recurrent stroke. Brain Sci. Phrases used: “Recurrent stroke,” “prevention,” “medications,” and “lifestyle changes.” • Summary of Evidence: ! Conclusions After an initial stroke, persistent smoking increases the risk of stroke recurrence. Alvarez et al27 did not observe a reduction in recurrent risk, possibly because of the small sample size and short follow‐up time. The similar dose–response relationships remained in the sensitivity analysis. The first three months after a stroke or ministroke, also called a transient ischemic attack (TIA), are the prime time for recurrent stroke or a heart attack. JAMA. Smoking status was assessed at baseline and reassessed at the first follow‐up. 2014;45:2160–2236. How Is Smoking Related to Heart Disease and Stroke? High blood pressure, or hypertension, is a leading cause of stroke and the most significant controllable risk factor. Wannamethee SG, Shaper AG, Whincup PH, Walker M. Chen Z, Peto R, Zhou M, Iona A, Smith M, Yang L, Guo Y, Chen Y, Bian Z, Lancaster G, Sherliker P, Pang S, Wang H, Su H, Wu M, Wu X, Chen J, Collins R, Li L; China Kadoorie Biobank (CKB) collaborative group. This study is supported by research grants from the National Natural Science Foundation of China (No. This study observed that patients who continued smoking after the index stroke had a nearly 2‐fold risk of stroke recurrence than nonsmokers. Cigarette smoking. Among the 233 female patients (all were non-smokers), 49 recurrent events and 11 competing events occurred. Among persistent smokers, hazard ratios for stroke recurrence ranged from 1.68 (95% CI , 1.14-2.48) in those who smoked 1 to 20 cigarettes daily to 2.72 (95% CI , 1.36-5.43) in those who smoked more than 40 cigarettes daily ( P for trend <0.001). Stroke survivors bear a higher risk of subsequent stroke, and recurrent stroke is more fatal and disabling than first‐ever stroke.10, 11 The 1‐year recurrence rate after the first‐ever stroke has been reported to be as high as 17.7% in Chinese patients.12 The prevalence of smoking has been reported to be as high as 52.9% in Chinese men.13 The high stroke recurrence and smoking prevalence in the Chinese population provided us with conditions to estimate the impact of smoking status on risk of stroke recurrence, and to determine whether a dose–response relationship exists. Cox proportional hazards regression was used to assess the association between smoking status and the risk of stroke recurrence by calculating hazard ratio (HR) and 95% CI. Hypertension (73.9%) is the most common risk factors, followed by smoking (20.4%), heart disease (19.9%), history of stroke (19.9%) and diabetes (17.3%).3,4 with antiplatelet has important role for medical Patients who have transient ischemic attack aOccupation: category I includes professionals, administrators, and technicians; category II, clerical and service workers; category III, manufacturing workers, peasants, and the jobless. Based on the analysis of the data showed that factors associated with the occurrence of recurrent stroke toward patients with post-stroke is a family history of stroke, hypertension, smoking… NSRP is a prospective, hospital‐based stroke registry. Studies about the impact of smoking on stroke recurrence are contradictory. If the patient could not answer the questionnaire, an appropriate proxy was invited. The association between smoking and the risk of stroke recurrence was analyzed with multivariate Cox regression model. Manage HBP. Tobacco taxes and prices have been substantially raised. CONCLUSION: The 1 year recurrent rate is about 11%, and monitoring the factors of atrial fibrillation, hyperlipemia, hypertension, and smoking may help reduce the recurrence of stroke. Printing the health hazards of smoking on the cigarette packages has become mandatory. The association between smoking and the risk of stroke recurrence was analyzed with multivariate Cox regression model. Multivariate analysis adjusted for age and gender identified atrial fibrillation, hypertension, hyperlipemia, family history of stroke, and smoking as the risk factors of stroke recurrence at 1 year. Figure 3. At the first follow-up, 908 (61.6%) patients quit smoking. The mean age was 59.6±11.7 years (range, 18–93 years), and 887 (28.9%) patients were women. 1-800-242-8721 Smoking is a major risk factor for future strokes, since it reduces the amount of oxygen in the blood. 2015 Oct 10;386(10002):1447-56. doi: 10.1016/S0140-6736(15)00340-2. After adjusting for major covariates, persistent smokers still had a higher likelihood of stroke recurrence when compared with nonsmokers (HR, 1.93; 95% CI, 1.43–2.61). eCollection 2020. Cigarette smoking. The effect of quitting may be partly attributable to lifestyle changes (eg, more exercise, healthier diet, and better compliance with medical advice among quitters).28, 36 Randomized control trials are likely to reduce such bias, and thus seem to be necessary. In univariate Cox analysis, when compared with nonsmokers, the unadjusted HRs for stroke recurrence were 1.26 (95% CI, 0.82–1.93) in former smokers, 1.20 (95% CI, 0.90–1.60) in quitters, and the HR increased significantly among persistent smokers (HR, 1.52; 95% CI, 1.13–2.05). In this study, because of changes of smoking behavior (eg, smoking cessation and resumption or smoking reduction) after the first stroke, we just detected the association according to their baseline smoking status among persistent smokers. aAdjusted for age, sex, BMI, NIHSS score, TOAST, hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, CHD, and socioeconomic status, including occupation, education years, annual family income, and rural residence. Multiple imputation with chain equations was performed to account for missing values. Persistent smokers were stratified according to smoking intensity at baseline into 3 levels, and according to smoking pack‐years into 4 levels (quartiles). What can stroke patients do to avoid a recurrence? 4 Equally important is the approximate 10% risk of stroke within 90 days after a TIA, which is significantly greater within the first week. The risk of recurrent stroke is estimated to be 3% to 10% within the first 30 days and increases to 25% to 40% 5 years after the initial stroke. Conclusions: The absolute and relative risks of recurrent stroke are highest early after the first stroke but remain elevated for several years thereafter. They had a higher proportion of alcohol drinking (36.6% versus 6.6%, P<0.001, Table S1). Methods and Results Patients with first-ever stroke were enrolled and followed in the NSRP (Nanjing Stroke Registry Program). The aim of this study was to identify the risk factors for early and late recurrent ischemic stroke. Nicotine Tob Res. The risk of fatal and non-fatal cardiovascular events was 6.2%. RESULTS: A total of 594 stroke patients were recruited. Please enable it to take advantage of the complete set of features! Cha JJ, Lee KY, Chung H, Kim IS, Choi EY, Min PK, Yoon YW, Lee BK, Hong BK, Rim SJ, Kwon HM, Kim JY. Those with 0.05 to 24.50, 24.50 to 39.00, 39.00 to 58.75, and 58.75 or more pack‐years had corresponding HRs of 1.35 (95% CI, 0.72–2.56), 1.78 (95% CI, 1.02–3.10), 1.93 (95% CI, 1.18–3.18), and 2.60 (95% CI, 1.70–3.98, P for trend <0.001, Tables 4 and 5). In this study, we observed a nonsignificant 22% decrease in recurrent risk among quitters, probably because of the relatively short follow‐up time. 1 in 4 stroke and heart attack survivors will have another. Smoking status was assessed at baseline and reassessed at the first follow-up. When compared with nonsmokers, only persistent smokers had a significantly higher HR for total stroke recurrence (HR, 1.75; 95% CI, 1.23–2.47) and ischemic stroke recurrence (HR, 1.84; 95% CI, 1.28–2.64).