Advertisement
Research Article| Volume 312, ISSUE 1-2, P79-81, January 15, 2012

Download started.

Ok

Short-term risk and predictors of stroke after transient ischemic attack

Published:August 29, 2011DOI:https://doi.org/10.1016/j.jns.2011.08.018

      Abstract

      Background

      Transient ischemic attack (TIA) is a marker of stroke, especially in the early phase following this event. The aims of this study are to determine the short-term risk of stroke and to evaluate the independent predictors of stroke in patients with TIA who are hospitalized within 48 hours after symptom onset.

      Methods

      During a 36-month period (beginning in November 2007), 3554 patients (mean age: 70.5±13 years; 49.9% female; mean NIHSS score: 1.4±2.5) from 15 hospitals suffering from TIA were prospectively evaluated.

      Results

      Of the 3554 patients, 43 (1.2%) suffered from stroke during hospitalization (6.5 ± 4.3 days). We identified the following independent predictors for stroke after TIA: male sex (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.3–5; P=0.008), age65 years (OR, 4.7; 95% CI, 1.4–15; P=0.01), hyperlipidemia (OR, 2.4; 95% CI, 1.2–4.8; P=0.015), and dysarthria (OR, 2; 95% CI, 1.1–5.0; P=0.038).

      Conclusion

      Patient characteristics (male sex, age, and hyperlipidemia) and TIA symptom (dysarthria) may be useful in defining stroke after TIA in patients who were hospitalized with TIA.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Neurological Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Brown Jr., R.D.
        • Petty G.W.
        • O'Fallon W.M.
        • Wiebers Do
        • Whisnant J.P.
        Incidence of transient ischemic attack in Rochester, Minnesota, 1985–1989.
        Stroke. 1998; 29: 2109-2113
        • Coull A.J.
        • Lovett J.K.
        • Rothwell P.M.
        Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services.
        BMJ. 2004; 328: 326-328
        • Lovett J.K.
        • Dennis M.S.
        • Sandercock P.A.
        • Bamford J.
        • Warlow C.P.
        • Rothwell P.M.
        Very early risk of stroke after a first transient ischemic attack.
        Stroke. 2003; : 34138-34140
        • Johnston S.C.
        • Nguyen-Huynh M.N.
        • Schwarz M.E.
        • Fuller K.
        • Williams C.E.
        • Josephson S.A.
        • et al.
        National Stroke Association guidelines for the management of transient ischemic attacks.
        Ann Neurol. 2006; 60: 301-313
        • Easton J.D.
        • Saver J.L.
        • Albers G.W.
        • Alberts M.J.
        • Chaturvedi S.
        • Feldmann E.
        • et al.
        Definition and evaluation of transient ischemic attack.
        Stroke. 2009; 40: 2276-2293
        • The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee
        Guidelines for management of ischaemic stroke and transient ischaemic attack 2008.
        Cerebrovasc Dis. 2008; 25: 457-507
        • Ringelstein E.B.
        • Berlit P.
        • Busse O.
        • Diener C.
        • Grotemeyer K.H.
        • Haberl R.L.
        • et al.
        Concept of supraregional and regional care of stroke patients in Germany.
        Akt Neurologie. 2000; 27: 101-103
        • Alberts M.J.
        • Hademenos G.
        • Latchaw R.E.
        • Jagoda A.
        • Marler J.P.
        • Mayberg M.R.
        • et al.
        Recommendations for the establishment of primary stroke centers. Brain Attack Coalition.
        JAMA. 2000; 283: 3102-3109
        • Edlow J.A.
        • Kim S.
        • Pelletier A.J.
        • Camargo Jr., C.A.
        National study on emergency department visits for transient ischemic attack, 1992–2001.
        Acad Emerg Med. 2006; 13: 666-672
        • Ovbiagele B.
        • Saver J.L.
        • Fredieu A.
        • Suzuki S.
        • Selco Rajajee V.
        • et al.
        In-hospital initiation of secondary stroke prevention therapies yields high rates of adherence at follow-up.
        Stroke. 2004; 35: 2879-2883
        • Meseguer E.
        • Lavallée P.C.
        • Mazighi M.
        • Labreuche J.
        • Cabrejo L.
        • Olivot J.M.
        • et al.
        Yield of systematic transcranial Doppler in patients with transient ischemic attack.
        Ann Neurol. 2010; 68: 9-17
        • Rothwell P.M.
        • Giles M.F.
        • Chandrateva A.
        • Marquardt L.
        • Geraghty O.
        • Redgrave J.N.E.
        • et al.
        Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison.
        Lancet. 2007; 370: 1432-1442
        • Lavallée P.C.
        • Meseguer E.
        • Abboud H.
        • Cabrejo L.
        • Olivot J.-M.
        • Simon O.
        • et al.
        A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects.
        Lancet Neurol. 2007; 6: 953-960
        • Johnston S.C.
        • Gress D.R.
        • Browner W.S.
        • Sidney S.
        Short-term prognosis after emergency department diagnosis of TIA.
        JAMA. 2000; 284: 2901-2906
        • Dennis M.
        • Bamford J.
        • Sandercock P.
        • Warlow C.
        Prognosis of transient ischemic attacks in the Oxfordshire Community Stroke Project.
        Stroke. 1990; 21: 848-853
        • Rothwell P.M.
        • Giles M.F.
        • Flossmann E.
        • Lovelock C.E.
        • Redgrave J.N.
        • Warlow C.P.
        • et al.
        A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack.
        Lancet. 2005; 366: 29-36
        • Johnston S.C.
        • Rothwell P.M.
        • Nguyen-Huynh M.N.
        • Giles M.F.
        • Elkins J.S.
        • Bernstein A.L.
        • et al.
        Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack.
        Lancet. 2007; 369: 283-292