Stroke survivors remain at high risk for another stroke or other serious medical problems and death for at least five years, a new study suggests.
The findings may mean that stroke survivors require closer follow-up to prevent these health problems, the Canadian researchers said.
"This high long-term risk was surprising and shows that we need to develop better strategies and interventions for these patients to prevent as many of these serious problems as we can," study leader Dr. Richard Swartz, director of the University of Toronto stroke program, said in a Heart and Stroke Foundation of Canada news release.
In the study, Swartz's team analyzed data from about 24,000 patients in Canada who suffered a stroke or mini-stroke, clinically known as a "transient ischemic attack" (TIA).
All of the patients had already survived the "high-danger" period, which is typically thought to be the 90 days after hospital discharge.
However, within the first year after this high-risk period, 9.3 percent of the patients died, had a repeat stroke, mini-stroke, heart attack or were admitted to long-term care. Death was the most common of these events, affecting more than 5 percent of patients in the first year.
Among patients who were still alive after a year, the rate of these events remained at 5 percent in each of the following four years, according to the study to be presented Tuesday at the Canadian Stroke Congress in Vancouver.
"We now need to identify ways to determine which people, among those who have made it through the riskiest period, remain most at risk for serious events so we can develop appropriate preventive interventions," Swartz said.
He and his colleagues are now investigating how factors such as depression, obstructive sleep apnea, and mental impairment may affect stroke survivors' risk of serious health problems and death.
One expert agreed that longer patient monitoring may be needed.
"This highlights the need to aggressively control stroke risk factors continuously after stroke or TIA, not just over the several months after the event," said Dr. Mandip Dhamoon, assistant professor of neurology at the Icahn School of Medicine at Mount Sinai in New York City.