In a nutshell
This study aimed to assess the 1 year risk of stroke after TIA or minor stroke. The authors concluded that in patients with TIA, there was a lower risk of cardiovascular event than previously reported.
Some background
Previous studies estimated the risk of stroke after transient ischemic attack (TIA, temporary blocked blood vessel carrying blood to the brain) to be between 12% and 20%. In the past several years, however, there have been changes in stroke prevention measures including, fast and immediate treatment of TIA and minor stroke patients. Current guidelines recommend assessing patients based on ABCD scores, which looks at age, blood pressure, clinical findings, duration of symptoms and diabetes. Therefore, patients with a higher score are considered at a higher risk and need to be treated immediately. It is not clear what the risk of further stroke or cardiovascular event is after 1 year.
Methods & findings
The authors identified 4583 patients who had presented within 7 days of TIA. 78.4% of these patients were examined by stroke specialists within 24 hours. The main symptoms presented were weakness (55%) and speech abnormalities (48.3%).
After 1 year, 274 events had occurred, including 25 deaths from cardiovascular event, 210 nonfatal strokes and 39 nonfatal acute coronary syndromes.
Overall, 5.1% of the TIA patients had a stroke within 1 year. The majority of these patients had high ABCD scores, multiple cerebral infarctions (blocked blood vessels that supply blood to the brain) and artery atherosclerosis (hardening of the arteries of the heart).
The bottom line
The authors concluded that the risk of further cardiovascular events following TIA were lower than reported in previous studies. They suggested that this could be due to better stroke prevention management.
The fine print
The study selected centers with TIA treatment facilities rather than choosing centres at random.
Published By :
The New England Journal of Medicine
Date :
Apr 21, 2016
