{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:45:01Z","timestamp":1782992701139,"version":"3.54.5"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Previous studies on stroke recurrence often ignored the competing risk of death, potentially biasing risk estimates. This study estimated stroke recurrence risk and identified associated factors among patients with first\u2010ever stroke in South London while accounting for competing mortality risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Data were obtained from the SLSR (South London Stroke Register), including patients with first\u2010ever stroke between 1995 and 2019. Stroke recurrence was analyzed using the cumulative incidence function and Fine\u2013Gray competing risk models, with death treated as a competing event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 5509 patients were included, of whom 4692 (85.1%) had ischemic stroke (IS) and 817 (14.8%) hemorrhagic stroke. During 34\u2009874 person\u2010years of follow\u2010up, 680 (12.3%) stroke recurrences and 2666 (48.4%) deaths were observed. Most recurrent strokes were ISs (75.3%). The cumulative recurrence risk was 9.6%, 14.1%, and 15.2% at 5, 15, and 25\u2009years, respectively. The 10\u2010year recurrence risk was higher after IS (12.7%) than hemorrhagic stroke (11.1%). For IS, higher recurrence risk was associated with earlier cohorts, Black race (subdistribution hazard ratio [SHR], 1.28 [95% CI, 1.04\u20131.58]), hypertension (SHR, 1.45 [95% CI, 1.18\u20131.78]), transient ischemic attack (SHR, 1.35 [95% CI, 1.06\u20131.70]), and lack of hospital admission (SHR, 1.40 [95% CI, 1.07\u20131.82]). For hemorrhagic stroke, recurrence risk was higher among patients with diabetes (SHR, 1.89 [95% CI, 1.10\u20133.23]) and differed by hemorrhage subtype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Stroke recurrence risk remains substantial following both IS and hemorrhagic stroke. Accounting for death as a competing risk provides more accurate estimates and highlights the importance of demographic and clinical factors in recurrence prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043626","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:34:22Z","timestamp":1773138862000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Risk of Stroke Recurrence: A \u00a0Competing Risk Analysis Based on the South London Stroke Register"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6428-0182","authenticated-orcid":false,"given":"Li","family":"Zhang","sequence":"first","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]},{"name":"University of Oxford","place":["Oxford, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Delord","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2594-2654","authenticated-orcid":false,"given":"Iain","family":"Marshall","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-0981","authenticated-orcid":false,"given":"Charles","family":"Wolfe","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]},{"name":"NIHR Applied Research Collaboration (ARC) South London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0768-1676","authenticated-orcid":false,"given":"Yanzhong","family":"Wang","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]},{"name":"NIHR Applied Research Collaboration (ARC) South London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D. 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