Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services

• Published in: BMJ Vol. 328; no. 7435; pp. 326 - 328
• Main Authors: Coull, A J, Lovett, J K, Rothwell, P M
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 07.02.2004; BMJ Publishing Group; British Medical Association; BMJ Publishing Group LTD; BMJ Publishing Group Ltd
• Edition: International edition
• Subjects: Aged; Biological and medical sciences; Cohort Studies; Emergency departments; Female; General practice; Hospital admissions; Humans; Ischemic Attack, Transient - complications; Male; Medical sciences; Medical treatment; Neurology; Nurses; Physicians; Population studies; Prevention; Primary Care; Primary health care; Prospective Studies; Public health; Recurrence; Risk Factors; Stroke; Stroke - etiology; Strokes; Studies; Transient ischemic attack; Vascular diseases and vascular malformations of the nervous system; United Kingdom; Europe; Oxford England; Human; Nervous system diseases; Stroke; Organization; Indication; Cardiovascular disease; Risk; Health education; Care; Transitory; Cerebral disorder; Vascular disease; Prevention; Ischemia; Central nervous system disease; Risk factor; Early; Cerebrovascular disease; Public health
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.37991.635266.44

Abstract Objective To estimate the very early stroke risk after a transient ischaemic attack (TIA) or minor stroke and thereby inform the planning of effective stroke prevention services. Design Population based prospective cohort study of patients with TIA or stroke. Setting Nine general practices in Oxfordshire, England, from April 2002 to April 2003. Participants All patients who had a TIA (n = 87) or minor stroke (n = 87) during the study period and who presented to medical attention. Main outcome measures Risk of recurrent stroke at seven days, one month, and three months after TIAs and minor strokes. Results The estimated risk of recurrent stroke was 8.0% (95% confidence interval 2.3% to 13.7%) at seven days, 11.5% (4.8% to 18.2%) at one month, and 17.3% (9.3% to 25.3%) at three months after a TIA. The risks at these three time periods after a minor stroke were 11.5% (4.8% to 11.2%), 15.0% (7.5% to 22.5%), and 18.5% (10.3% to 26.7%). Conclusions The early risks of stroke after a TIA or minor stroke are much higher than commonly quoted. More research is needed to determine whether these risks can be reduced by more rapid instigation of preventive treatment.