- Black patients had a 60% higher adjusted risk for recurrence within 90 days of a minor ischemic stroke or transient ischemic attack (TIA) compared with white counterparts.
Why this matters
- Findings may support risk-stratified poststroke care, with intensified secondary intervention efforts for black survivors.
- Cumulative 90-day risk for new ischemic stroke:
- 8.5% among black patients and
- 5.3% among white patients.
- Fully adjusted recurrence risk was higher for black vs white patients (HR, 1.6; 95% CI, 1.1-2.3).
- Findings were similar:
- Disregarding the incident event (TIA vs minor stroke),
- Restricting analyses to sites enrolling black patients,
- Using propensity score adjustment, and
- Imputing missing race/ethnicity.
- No significant interaction between black race and age, treatment assignment, lacunar vs nonlacunar index event, baseline systolic BP.
- Risk not significantly increased for patients of other races.
- Secondary analysis of US multicenter randomized controlled trial of antiplatelet therapy for minor ischemic stroke or high-risk TIA (POINT trial).
- 4044 adults within 12 hours of onset: 72.7% white, 22.7% black, 4.5% of other races.
- Main outcome: new ischemic stroke within 90 days.
- Funding: National Institute of Neurological Disorders and Stroke; NIH.
- Uncertain generalizability.
- Residual, unmeasured confounding.
- Lack of follow-up beyond 90 days.