White matter hyperintensity load on stroke recurrence and mortality at 1 year after ischemic stroke

Objective: We set out to define the role and risks associated with white matter hyperintensity (WMH) load in a stroke population with respect to recurrent stroke and mortality after ischemic stroke. Methods: A total of 7,101 patients at a network of university hospitals presenting with ischemic strokes were followed for one year. Multivariable Cox proportional-hazards model and competing risk analysis were used to examine the independent association between quartiles of WMH load and stroke recurrence and mortality at one year. Results: Overall recurrent stroke risk at one year was 6.7%/yr, divided between 5.6%/yr for recurrent ischemic and 0.5%/yr for recurrent hemorrhagic strokes. There was a stronger association between WMH volume and recurrent hemorrhagic stroke by quartile (Hazard ratios [HR] of 7.32, 14.12, and 33.52, respectively) than for ischemic recurrence (HR of 1.03, 1.37, and 1.61, respectively), but the absolute incidence of ischemic recurrence by quartile was higher (3.8%/...