The aim of this study is to determine if there was an association of stroke recurrence with metabolic syndrome (MetS), defined by the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-III) report or the International Diabetes Federation (IDF), as well as with other risk factors, including albuminuria. From February 1, 2004 to February 5, 2006, 523 patients were admitted to our Stroke Care Unit within 7 days of stroke onset. After excluding 22 patients who died in hospital and 27 patients who did not provide consent, 474 survivors (M/F=313/161, median age, 71 years) were enrolled. End-point events were fatal or nonfatal stroke. Diagnosis of MetS by NCEP-III criteria was made in 33% of patients, and by IDF criteria in 26%. During follow-up (505.4 person-years), 2 patients dropped out. Forty-nine patients among 370 with ischemic stroke and 5 patients among 102 patients with brain hemorrhage had stroke recurrence, being fatal in 3. A significant predictor of recurrence was albuminuria (HR: 1.835, 95% CI: 1.005-3.350) in ischemic stroke. There were no significant predictors of stroke recurrence in patients with brain hemorrhage. In conclusion, albuminuria, but not MetS, was a significant predictor of stroke recurrence in ischemic stroke.