Clinical Edge

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Recurrent Stroke Linked with Not Having a PCP

Neurology; ePub 2019 Jan 4; Lank, et al

A recent study found lower rates of stroke recurrence among those with a primary care physician (PCP) at the time of first stroke. First-ever ischemic stroke patients aged 45 to 64 years at stroke onset were ascertained through the Brain Attack Surveillance in Corpus Christi (BASIC) project from 2000 to 2013. Cox proportional hazards models were used to examine the association between not having a PCP and stroke recurrence or all-cause mortality in separate models. Cases were followed up for up to 5 years or until December 31, 2013, whichever came first. Cases were censored for recurrence if they died before experiencing a recurrent event. Researchers found:

  • There were 663 first-occurrence ischemic stroke cases.
  • Of these, 77% had a PCP, 43% were female, and average age was 55.6 years.
  • 5-year recurrence risk was 14.6%, and mortality risk was 19.2%.
  • Not having a PCP was associated with higher recurrence risk (adjusted hazard ratio 1.75).
  • Having a PCP was not associated with mortality.

Lank RJ, Lisabeth LD, Sánchez BN, et al. Recurrent stroke in midlife is associated with not having a primary care physician. [Published online ahead of print January 4, 2019]. Neurology. doi:10.1212/WNL.0000000000006878.