ABSTRACT NUMBER: ESOC2026A1250 FUNCTIONAL, QUALITY-OF-LIFE, AND LIFE-EXPECTANCY CONSEQUENCES OF RECURRENT STROKE: 10-YEAR FOLLOW-UP OF A POPULATION-BASED COHORT

Abstract Background and aims Stroke negatively affects long-term outcomes. The additional impact of recurrent events that occur despite current best medical treatment (BMT) is less well understood. We aimed to quantify the long-term consequences of recurrent stroke on functional outcome, quality-of-life (QoL), and 10-year life-expectancy. Methods In a UK population-based incidence cohort, patients with first-in-study stroke/TIA (04/2002-03/2023) were given guideline-based BMT and followed-up in face-to-face visits to 10-years, with recurrent strokes identified using multiple other methods. Disability was defined as mRS≥3 and QoL was assessed using the EQ-5D-3L, and converted into utilities (0–1). The effect of recurrent stroke was estimated using Cox and multivariable fixed-effects regression. Results Among 3,775 stroke and 2,502 TIA patients, 642(17%) and 358(14%), respectively experienced ≥1 recurrent stroke. Each recurrence was associated with increased risk of death/disability (stroke-patients aHR=1.63,95%CI=1.46-1.81,p<0.001; TIA-patients 1.63,1.41-1.90,p<0.001) and reduced QoL at the subsequent follow-up (stroke -0.06, -0.09 to -0.04;p<0.001; TIA -0.05,-0.08 to -0.03;p<0.001). Quality-adjusted life-expectancy (QALE) for patients without recurrence was 5.22 (5.11-5.35) after stroke and 6.81 (6.58–7.02) years after TIA. After adjustment, each recurrent stroke reduced QALE by 0.48(-0.71 to -0.26;p<0.001) years in stroke and 0.17(-0.25 to -0.11;p<0.001) years in TIA patients. Further analyses by TOAST subtype, severity, age, high-risk TIA, and other factors will be presented. Conclusions Recurrent stroke rates are substantial despite current BMT and each recurrence increases death/disability and reduces QoL and healthy longevity, highlighting the continuing need for more effective secondary prevention. Conflict of interest RL-F, LS and PMR have received unrestricted educational research grants from Bayer, NIHR - Oxford Biomedical Research Centre, and Wellcome Trust