Differential risks of subsequent vascular events for transient ischaemic attack and minor ischaemic stroke

• Published in: Journal of clinical neuroscience Vol. 14; no. 1; pp. 17 - 21
• Main Authors: Lin, Huey-Juan, Yeh, Poh-Shiow, Tsai, Tsung-Chia, Cheng, Tain-Junn, Ke, Dershin, Lin, Kao-Chang, Ho, Jih-Gong, Chang, Chia-Yu
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.01.2007
• Subjects: Aged; Brain Ischemia - complications; Brain Ischemia - epidemiology; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - epidemiology; Female; Follow-Up Studies; Humans; Ischaemic stroke; Ischemic Attack, Transient - complications; Ischemic Attack, Transient - epidemiology; Ischemic Attack, Transient - pathology; Magnetic Resonance Angiography; Male; Middle Aged; Neurologic Examination; Neurology; Outcome; Prognosis; Prospective studies; Risk; Stroke - complications; Stroke - epidemiology; Stroke - pathology; Survival Analysis; Taiwan; Taiwan - epidemiology; Transient ischaemic attack; Treatment Outcome; Vascular Diseases - epidemiology; Vascular Diseases - etiology; Vascular Diseases - pathology; Taiwan; Prospective studies; Outcome; Ischaemic stroke; Transient ischaemic attack; Taiwan
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2005.07.026

Abstract Using a prospective hospital-based registry, 146 patients with transient ischaemic attack (TIA) were compared with 376 patients with minor first-ever ischaemic stroke with respect to the 3-month risk of subsequent vascular events, in order to clarify the distinctions between the disease entities. All patients were enrolled within 48 h of onset. The risk factor distribution for the two groups was comparable, except that the TIA patients had more previous TIAs. Large artery atherosclerosis (34%) and small vessel occlusion (32%) were the main aetiologies in the TIA group, whereas small vessel occlusion (49%) was the major cause in the stroke group. The 3-month risk of combined endpoints of stroke, myocardial infarction, and vascular death for TIA patients was higher than that for the minor stroke group (15.1% vs. 3.2%; hazard ratio 4.6, 95% confidence interval 2.3–9.3 in multivariate analysis). Large artery atherosclerosis and male sex were the other significant predictors. TIA may demand more urgent management than minor stroke. The fact that aetiology is a predictor, highlights the need for rapid diagnostic tests to establish pathogenesis.