Abstract Number: Esoc2026a1447 Vascular Risk Factor Control at Recurrent Ischemic Stroke Admission: Temporal Trends and Outcome Associations From a Nationwide Registry

Abstract Background and aims Recurrent ischemic stroke is associated with substantial disability and mortality, but attainment of key secondary-prevention risk-factor targets at recurrent-stroke admission is not well defined. Methods We analyzed adult acute stroke admissions recorded in the Korean Stroke Registry from 2018 to 2023, including 24,183 recurrent ischemic events. Risk-factor benchmarks were hemoglobin A1c (HbA1c) 7.0%, low-density lipoprotein cholesterol (LDL-C) 70 mg/dL, noncurrent smoking, and normal weight (body mass index 18.5–24.9 kg/m2). Temporal trends and effect modification by sex and age group were assessed using hospital-clustered generalized estimating equation logistic models. Associations between the number of controlled risk factors and discharge functional independence, as well as in-hospital mortality, were evaluated with multivariable adjustment. Results The mean age was 72.6 ± 12.3 years, and 39.6% were women. LDL-C control improved over time, with greater annual gains in women than men (odds ratio per year 1.12 vs 1.05; P for interaction0.001) and improvement confined to patients aged ≥50 years (P for interaction0.001). Hemoglobin A1c 7.0% was stable overall, with a borderline decline among patients aged 19–49 years (odds ratio per year 0.90). Noncurrent smoking increased in men but decreased in women (P for interaction0.001). Normal weight declined in women (P for interaction = 0.010) and younger adults (P for interaction0.001). Discharge functional independence increased, and in-hospital mortality decreased stepwise with a greater number of controlled risk factors. Conclusions Low-density lipoprotein cholesterol control improved, whereas gaps in glycemic status, smoking, and weight persisted, particularly among younger adults and women. Greater bundled risk-factor control was associated with better outcomes. Conflict of interest Eung-Joon Lee: Nothing to disclose. Figure 1 - belongs to Conclusions