Recurrent lacunar infarction following a previous lacunar stroke: a clinical study of 122 patients
- 1Cerebrovascular Division, Department of Neurology, University of Barcelona, Hospital del Sagrat Cor, Barcelona, Spain
- 2Clinical Information Systems, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Dr A Arboix, Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Viladomat 288, E-08029 Barcelona, Spain;
- Received 6 March 2007
- Revised 14 June 2007
- Accepted 23 June 2007
- Published Online First 5 July 2007
Objective: To determine clinical variables related to recurrent lacunar infarction following a previous lacunar stroke.
Methods: A total of 122 out of 733 consecutive patients with lacunar infarction collected from a hospital based registry between 1986 and 2004 were readmitted because of a recurrent lacunar infarction. In a subset of 59 patients, cognition was assessed using the Mini-Mental State Examination (MMSE). Predictors of lacunar infarction recurrence were assessed by logistic regression analysis.
Results: First lacunar infarction recurrence occurred in 101 patients (83%) and multiple recurrences in 21. The mean time between first ever lacunar infarction and recurrent lacunes was 58.3 months (range 2–240). In the subset of 59 patients in whom cognition was studied, cognitive impairment, defined as an MMSE score <24, was detected in 16% (8/49) of patients with first lacunar infarction recurrence and in 40% (4/10) of those with multiple lacunar infarction recurrences. In the multivariate analysis, hypertension (odds ratio 2.01, 95% CI 1.23 to 3.30) and diabetes (odds ratio 1.62, 95% CI 1.07 to 2.46) were significant predictors of lacunar stroke recurrence, whereas hyperlipidaemia was inversely associated (odds ratio 0.52, 95% CI 0.30 to 0.90).
Conclusions: Hypertension and diabetes were significant factors related to recurrent lacunar infarction. Hyperlipidaemia appeared to have a protective role. Cognitive impairment was a frequent finding in patients with multiple lacunar infarction recurrences.
Competing interests: None.
- Mini-Mental State Examination