Stroke Prevention: The Best Outcome after a Transient Ischemic Attack. Results from the Minnesota Stroke Registry and Opportunities to Improve Care.

A transient ischemic attack (TIA) is an opportunity for stroke prevention. We examined the care of 708 TIA patients entered into the Minnesota Stroke Registry (MSR) and analyzed the extent to which they were discharged on appropriate guideline-recommended secondary prevention treatments. We calculated the overall number of strokes prevented by multiple risk factor modifying treatments. Of the 708 TIA patients, 533 (75%) were discharged on antihypertensive treatment. Of 208 patients with an LDL-Cholesterol greater than 100 mg/dl, 131 (63%) patients were prescribed lipid-lowering medications. Anticoagulation treatment was prescribed in 76% (82 of 108) of patients diagnosed with atrial fibrillation during hospitalization. Anti-thrombotic therapy was prescribed in 94% (563 of 600) TIA patients without atrial fibrillation. We estimated that 104 strokes will be prevented over 5 years due to combining multiple treatments assuming a baseline stroke risk of 60% in atrial fibrillation patients and 17% in non-atrial fibrillation patients over 5 years.