BACKGROUND AND PURPOSE: Patients with TIA have a high short-time risk of stroke and an increased long-term risk of ischaemic vascular events compared with the general population. Urgent intervention may reduce short-time stroke risk, but little is known about the effect beyond 3 months. We examined 1-year outcome and risk factor management in patients with TIA after urgent intervention. METHODS: All patients with TIA referred to Aarhus University Hospital 1 March 2007-28 February 2008 were seen by an acute TIA team (ATT), integrating outpatient care and stroke unit facilities. Preventive treatment was initiated immediately, including fast-track surgery for carotid stenosis. Follow-up including nurse-conducted health counseling was carried out after 7, 90, and 365 days. RESULTS: A total of 306 patients were included. Stroke, myocardial infarction, or vascular death occurred in 5.2% during 1 year of follow-up. The cumulated stroke rate was 1.6%, 2.0%, and 4.4% after 7, 90, and 365 days, respectively, compared to expected 4.5% [relative risk (RR) 0.36, 95% CI 0.13-0.98] and 7.5% (RR 0.26, 95% CI 0.11-0.63) after 7 and 90 days using ABCD(2) criteria. Recurrent TIA occurred in 10.2% (n = 32). Secondary prevention targets were attained in 47.6% after 1 year. Carotid surgery was performed in 8.1%; median time to operation was 11 days after contact with the ATT. CONCLUSION: Urgent intervention after TIA by an ATT covering outpatient and stroke unit facilities combined with nurse-conducted health counseling is associated with a low 1-year risk of new vascular events and may improve risk factor control.
BACKGROUND AND PURPOSE:Patients with TIA have a high short-time risk of stroke and an increased long-term risk of ischaemic vascular events compared with the general population. Urgent intervention may reduce short-time stroke risk, but little is known about the effect beyond 3 months. We examined 1-year outcome and risk factor management in patients with TIA after urgent intervention. METHODS: All patients with TIA referred to Aarhus University Hospital 1 March 2007-28 February 2008 were seen by an acute TIA team (ATT), integrating outpatient care and stroke unit facilities. Preventive treatment was initiated immediately, including fast-track surgery for carotid stenosis. Follow-up including nurse-conducted health counseling was carried out after 7, 90, and 365 days. RESULTS: A total of 306 patients were included. Stroke, myocardial infarction, or vascular death occurred in 5.2% during 1 year of follow-up. The cumulated stroke rate was 1.6%, 2.0%, and 4.4% after 7, 90, and 365 days, respectively, compared to expected 4.5% [relative risk (RR) 0.36, 95% CI 0.13-0.98] and 7.5% (RR 0.26, 95% CI 0.11-0.63) after 7 and 90 days using ABCD(2) criteria. Recurrent TIA occurred in 10.2% (n = 32). Secondary prevention targets were attained in 47.6% after 1 year. Carotid surgery was performed in 8.1%; median time to operation was 11 days after contact with the ATT. CONCLUSION: Urgent intervention after TIA by an ATT covering outpatient and stroke unit facilities combined with nurse-conducted health counseling is associated with a low 1-year risk of new vascular events and may improve risk factor control.
Authors: Moira K Kapral; Ruth Hall; Jiming Fang; Peter C Austin; Frank L Silver; David J Gladstone; Leanne K Casaubon; Melissa Stamplecoski; Jack V Tu Journal: Neurology Date: 2016-03-25 Impact factor: 9.910
Authors: S Hastrup; S P Johnsen; M Jensen; P von Weitzel-Mudersbach; C Z Simonsen; N Hjort; A T Møller; T Harbo; M S Poulsen; H K Iversen; D Damgaard; G Andersen Journal: Neurology Date: 2021-01-20 Impact factor: 9.910