| アブストラクト | BACKGROUND AND PURPOSE: Data about variations in stroke incidence and subsequent major adverse outcomes are essential to inform secondary prevention and prioritizing resources to those at the greatest risk of major adverse end points. We aimed to describe the age, sex, and socioeconomic differences in the rates of first nonfatal stroke and subsequent major adverse outcomes. METHODS: The cohort study used linked Clinical Practice Research Datalink and Hospital Episode Statistics data from the United Kingdom. The incidence rate (IR) ratio of first nonfatal stroke and subsequent major adverse outcomes (composite major adverse cardiovascular events, recurrent stroke, cardiovascular disease-related, and all-cause mortality) were calculated and presented by year, sex, age group, and socioeconomic status based on an individual's location of residence, in adults with incident nonfatal stroke diagnosis between 1998 and 2017. RESULTS: A total of 82 774 first nonfatal stroke events were recorded in either primary care or hospital data-an IR of 109.20 per 100 000 person-years (95% CI, 108.46-109.95). Incidence was significantly higher in women compared with men (IR ratio, 1.13 [95% CI, 1.12-1.15]; P<0.001). Rates adjusted for age and sex were higher in the lowest compared with the highest socioeconomic status group (IR ratio, 1.10 [95% CI, 1.08-1.13]; P<0.001). For subsequent major adverse outcomes, the overall incidence for major adverse cardiovascular event was 38.05 per 100 person-years (95% CI, 37.71-38.39) with a slightly higher incidence in women compared with men (38.42 versus 37.62; IR ratio, 1.02 [95% CI, 1.00-1.04]; P=0.0229). Age and socioeconomic status largely accounted for the observed higher incidence of adverse outcomes in women. CONCLUSIONS: In the United Kingdom, incidence of initial stroke and subsequent major adverse outcomes are higher in women, older populations, and people living in socially deprived areas. |
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| 投稿者 | Akyea, Ralph K; Vinogradova, Yana; Qureshi, Nadeem; Patel, Riyaz S; Kontopantelis, Evangelos; Ntaios, George; Asselbergs, Folkert W; Kai, Joe; Weng, Stephen F |
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| 組織名 | Primary Care Stratified Medicine, Division of Primary Care, University of;Nottingham, Nottingham, United Kingdom (R.K.A., Y.V., N.Q., J.K., S.F.W.).;Institute of Cardiovascular Science, Faculty of Population Health Sciences;(R.S.P., F.W.A.), University College London.;Health Data Research UK, Institute of Health Informatics (R.S.P., F.W.A.),;University College London.;Division of Population Health, Health Services Research and Primary Care (E.K.),;School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester;Academic Health Science Centre (MAHSC), The University of Manchester, United;Kingdom.;Division of Informatics, Imaging, and Data Sciences (E.K.), School of Health;Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health;Science Centre (MAHSC), The University of Manchester, United Kingdom.;Department of Internal Medicine, Faculty of Medicine, School of Health Sciences,;University of Thessaly, Larissa, Greece (G.N.).;Division Heart and Lungs, Department of Cardiology, University Medical Center;Utrecht, Utrecht University, the Netherlands (F.W.A.). |
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