BACKGROUND: Stroke and mortality rates in patients with transient ischemic attack (TIA) differ widely between community-based studies and research cohorts. Our aim therefore was to provide a reliable estimate for TIA patients treated in German neurology departments with an acute stroke unit. METHODS: A total of 1951 consecutively admitted TIA patients were prospectively documented in 13 centers and 1480 (75.9%) gave consent for long-term follow-up. During a mean follow-up of 23.4 months, we assessed recurrent cerebrovascular events and cause of death in 1448 patients via standardized telephone interview including confirmation of endpoint events by the treating physician. RESULTS: Overall 94 patients (6.5%) suffered a stroke and 118 patients (8.1%) died, 21 due to stroke. The Kaplan-Meier estimate for stroke during the first year was 4.4% (95% CI 3.2-5.6%) which corresponds to a relative risk of 9.5 (95% CI 7.4-12.3) compared to the population-based stroke incidence in Germany. The annual rates after the first year were 2.2% (95% CI 1.7-2.7%) for stroke and 3.2% (95% CI 2.7-3.8%) for death. Independent predictors for stroke during follow-up were age and previous cerebrovascular events. The ABCD(2) score did not provide any meaningful prediction of stroke risk at 90 days. CONCLUSION: While the in-hospital risk of stroke was low, long-term stroke rates in our well-defined multicenter hospital-based cohort were comparable to a large randomized trial. In patients with a well-established diagnosis of TIA, only age and previous cerebrovascular events seem to constitute independent predictors for stroke during long-term follow-up.
BACKGROUND:Stroke and mortality rates in patients with transient ischemic attack (TIA) differ widely between community-based studies and research cohorts. Our aim therefore was to provide a reliable estimate for TIApatients treated in German neurology departments with an acute stroke unit. METHODS: A total of 1951 consecutively admitted TIApatients were prospectively documented in 13 centers and 1480 (75.9%) gave consent for long-term follow-up. During a mean follow-up of 23.4 months, we assessed recurrent cerebrovascular events and cause of death in 1448 patients via standardized telephone interview including confirmation of endpoint events by the treating physician. RESULTS: Overall 94 patients (6.5%) suffered a stroke and 118 patients (8.1%) died, 21 due to stroke. The Kaplan-Meier estimate for stroke during the first year was 4.4% (95% CI 3.2-5.6%) which corresponds to a relative risk of 9.5 (95% CI 7.4-12.3) compared to the population-based stroke incidence in Germany. The annual rates after the first year were 2.2% (95% CI 1.7-2.7%) for stroke and 3.2% (95% CI 2.7-3.8%) for death. Independent predictors for stroke during follow-up were age and previous cerebrovascular events. The ABCD(2) score did not provide any meaningful prediction of stroke risk at 90 days. CONCLUSION: While the in-hospital risk of stroke was low, long-term stroke rates in our well-defined multicenter hospital-based cohort were comparable to a large randomized trial. In patients with a well-established diagnosis of TIA, only age and previous cerebrovascular events seem to constitute independent predictors for stroke during long-term follow-up.
Authors: Christian Weimar; Klaus Kraywinkel; Joachim Rödl; André Hippe; Lutz Harms; Antje Kloth; Hans-Christoph Diener Journal: Arch Neurol Date: 2002-10
Authors: G Howard; G W Evans; J R Crouse; J F Toole; J E Ryu; C Tegeler; J Frye-Pierson; E Mitchell; L Sanders Journal: Stroke Date: 1994-02 Impact factor: 7.914
Authors: F Purroy; P E Jiménez Caballero; A Gorospe; M J Torres; J Alvarez-Sabin; P Martínez-Sánchez; D Cánovas; M Freijo; J A Egido; J M Ramírez-Moreno; A Alonso-Arias; A Rodríguez-Campello; I Casado-Naranjo; J Martí-Fàbregas; Y Silva; P Cardona; A Morales; A García-Pastor; J F Arenillas; T Segura; C Jiménez; J Masjuán Journal: J Neurol Date: 2014-06-10 Impact factor: 4.849
Authors: Durgesh Chaudhary; Vida Abedi; Jiang Li; Clemens M Schirmer; Christoph J Griessenauer; Ramin Zand Journal: Front Neurol Date: 2019-11-12 Impact factor: 4.003