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Predictors of Mortality in Patients With Lacunar Stroke in the Secondary Prevention of Small Subcortical Strokes Trial

BACKGROUND AND PURPOSE—The Secondary Prevention of Small Subcortical Stroke trial (SPS3) recruited participants meeting clinical and radiological criteria for symptomatic lacunes. Individuals randomized to dual antiplatelet therapy with clopidogrel and aspirin had an unanticipated increase in all-ca...

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Published in:Stroke (1970) 2014-10, Vol.45 (10), p.2989-2994
Main Authors: Sharma, Mukul, Pearce, Lesly A, Benavente, Oscar R, Anderson, David C, Connolly, Stuart J, Palacio, Santiago, Coffey, Christopher S, Hart, Robert G
Format: Article
Language:English
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Summary:BACKGROUND AND PURPOSE—The Secondary Prevention of Small Subcortical Stroke trial (SPS3) recruited participants meeting clinical and radiological criteria for symptomatic lacunes. Individuals randomized to dual antiplatelet therapy with clopidogrel and aspirin had an unanticipated increase in all-cause mortality compared with those assigned to aspirin. We investigated the factors associated with mortality in this well-characterized population. METHODS—We identified independent predictors of mortality among baseline demographic and clinical factors by Cox regression analysis in participants of the SPS3 trial. Separately, we examined the effect on mortality of nonfatal bleeding during the trial. RESULTS—During a mean follow-up of 3.6 years, the mortality rate was 1.78% per year for the 3020 participants (mean age, 63 years). Significant independent predictors of mortality at study entry were age, diabetes mellitus, history of hypertension, systolic blood pressure (hazard ratio [HR], 1.3 per 20 mm Hg increase), serum hemoglobin
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.114.005789