One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke
Lavallée, Philippa C.
Albers, Gregory W.
Bornstein, Natan M.
Caplan, Louis R.
Donnan, Geoffrey A.
Ferro, José M.
Hennerici, Michael G.
Rothwell, Peter M.
Steg, Philippe Gabriel
Wong, Lawrence K.S
the TIAregistry.org Investigators
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BACKGROUND Previous studies conducted between 1997 and 2003 estimated that the risk of stroke or an acute coronary syndrome was 12 to 20% during the first 3 months after a transient ischemic attack (TIA) or minor stroke. The TIAregistry.org project was designed to describe the contemporary profile, etiologic factors, and outcomes in patients with a TIA or minor ischemic stroke who receive care in health systems that now offer urgent evaluation by stroke specialists. METHODS We recruited patients who had had a TIA or minor stroke within the previous 7 days. Sites were selected if they had systems dedicated to urgent evaluation of patients with TIA. We estimated the 1-year risk of stroke and of the composite outcome of stroke, an acute coronary syndrome, or death from cardiovascular causes. We also examined the association of the ABCD2 score for the risk of stroke (range, 0 [lowest risk] to 7 [highest risk]), findings on brain imaging, and cause of TIA or minor stroke with the risk of recurrent stroke over a period of 1 year. RESULTS From 2009 through 2011, we enrolled 4789 patients at 61 sites in 21 countries. A total of 78.4% of the patients were evaluated by stroke specialists within 24 hours after symptom onset. A total of 33.4% of the patients had an acute brain infarction, 23.2% had at least one extracranial or intracranial stenosis of 50% or more, and 10.4% had atrial fibrillation. The Kaplan–Meier estimate of the 1-year event rate of the composite cardiovascular outcome was 6.2% (95% confidence interval, 5.5 to 7.0). Kaplan–Meier estimates of the stroke rate at days 2, 7, 30, 90, and 365 were 1.5%, 2.1%, 2.8%, 3.7%, and 5.1%, respectively. In multivariable analyses, multiple infarctions on brain imaging, large-artery atherosclerosis, and an ABCD2 score of 6 or 7 were each associated with more than a doubling of the risk of stroke. CONCLUSIONS We observed a lower risk of cardiovascular events after TIA than previously reported. The ABCD2 score, findings on brain imaging, and status with respect to large-artery atherosclerosis helped stratify the risk of recurrent stroke within 1 year after a TIA or minor stroke. (Funded by Sanofi and Bristol-Myers Squibb.)
Is part ofThe New England Journal of Medicine, 2016, núm. 374, p. 1533-1542
European research projects
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Amarenco, Pierre; Lavallée, Philippa C.; Tavares, Linsay Monteiro; Labreuche, Julien; Albers, Gregory W.; Abboud, Halim; Anticoli, Sabrina; Audebert, Heinrich; Bornstein, Natan M.; Caplan, Louis R.; Correia, Manuel; Donnan, Geoffrey A.; Ferro, José M.; Gongora-Rivera, Fernando; Heide, Wolfgang; Hennerici, Michael G.; Kelly, Peter J.; Král, Michal; Lin, Hsiu-Fen; Molina, Carlos; Park, Jong Moo; Purroy Garcia, Francisco; Rothwell, Peter M.; Segura, Tomas; Školoudík, David; Steg, Philippe Gabriel; Touboul, Pierre-Jean; Uchiyama, Shinichiro; Vicaut, Éric; Wang, Yongjun; Wong, Lawrence K.S (Massachusetts Medical Society, 2018)BACKGROUND After a transient ischemic attack (TIA) or minor stroke, the long-term risk of stroke and other vascular events is not well known. In this follow-up to a report on 1-year outcomes from a registry of TIA clinics ...
Depression and Apathy After Transient Ischemic Attack or Minor Stroke: Prevalence, Evolution and Predictors Carnes Vendrell, Anna; Deus Yela, Juan; Molina Seguin, Jessica; Pifarré Paredero, Josep; Purroy Garcia, Francisco (Nature Research, 2019)Few previous studies have focused on affective impairment after transient ischemic attack (TIA) and/or minor stroke. The aim was to establish the prevalence, evolution and predictors of post-stroke depression (PSD) and ...
Jové Font, Mariona; Mauri-Capdevila, Gerard; Suárez-Luis, Idalmis; Cambray Carner, Serafí; Sanahuja Montesinos, Jordi; Quilez Martínez, Alejandro; Farré, Joan; Benabdelhak Abbou, Ikram; Pamplona Gras, Reinald; Portero Otín, Manuel; Purroy Garcia, Francisco (American Academy of Neurology, 2015)Objective: To discover, by using metabolomics, novel candidate biomarkers for stroke recurrence (SR) with a higher prediction power than present ones. Methods: Metabolomic analysis was performed by liquid chromatography ...