| Abstract [eng] |
After a first stroke, the risk of a second stroke is elevated. However, with early identification of the cause and comprehensive secondary prevention, this risk can be significantly reduced. The present study investigated demographic and clinical characteristics, stroke etiology, diagnostical tests performed, recommendations given and secondary prevention administered in individuals who had a recurrent ischaemic stroke within 1 year of the first ischaemic event. The study sample consisted of individuals with a recurrent ischaemic stroke occured in 2017, 2018, 2020 and 2021 years. Demographic and clinical characteristics, testing and secondary prevention strategies were analysed. Subsequently, the subjects were divided into two groups — strokes occurring before the COVID-19 pandemic (stroke in 2017-2018 y.) and during the pandemic (stroke in 2020-2021 y.) — and the same characteristics were compared between groups. The most common etiology of the first stroke was unknown, 31 (36.9%), and of the recurrent stroke, cardioembolic (CE) — 29 (34.5%). Strokes caused by large-artery atherosclerosis (LAA) and CE were more likely to be followed by recurrent strokes of the same etiology, whereas strokes caused by small vessel disease (SVD) were more likely to be followed by recurrent strokes of different etiology. The study found no significant difference in the number of strokes before and during the pandemic. In the 2020-2021 y. group, a lipidogram (p=0.004) and cholesterol-lowering therapy (p=0.02) were significantly more frequent. In the 2020-2021 group y. recommendations for dyslipidaemia (p=0.04) and hypertension (p=0.02) treatment targets were significantly more frequent, and there was a tendency towards more frequent lifestyle recommendations (p=0.09). Overall, there was a positive dynamic in secondary stroke prevention, with an increasing focus over 5 years on clarifying the etiology, correcting risk factors, and making more detailed lifestyle and treatment recommendations. |
