BACKGROUND AND PURPOSE: Differences in sex in the incidence, presentation, and outcome of events after ischemic stroke have been studied in depth. In contrast, only limited data are available after transient ischemic attack (TIA). We aim to assess sex-related differences in the presentation, cause, neuroimaging features, and predictors of long-term prognosis in patients with TIA. METHODS: We carried out a prospective cohort study of consecutive patients with TIA from January 2006 to June 2010. Nondefinitive TIA events were defined by the presence of isolated atypical symptoms. The risk of stroke recurrence (SR) and composite of major vascular events were stratified by sex after a median follow-up time of 6.5 (interquartile range, 5.0-9.6) years. RESULTS: Among the 723 patients studied, 302 (41.8%) were female and 79 (10.9%) suffered a nondefinitive TIA event. Vascular territory diffusion-weighted imaging patterns (odds ratio, 1.61 [95% CI, 0.94-2.77]), and nondefinitive TIA events (odds ratio, 2.66 [95% CI, 1.55-4.59]) were associated with women, whereas active smoking (odds ratio, 0.30 [95% CI, 0.15-0.58]) and large artery atherosclerosis causes (odds ratio, 0.50 [95% CI, 0.29-0.83]) were related to men. The risk of SR was similar in both sexes (12.6% [95% CI, 8.9-16.3] for women versus 14.3% [95% CI, 11.0-17.6] for men). In contrast, the risk of major vascular events was significantly lower in women than in men (17.5% [95% CI, 13.2-21.8] versus 23.8% [95% CI, 19.7-27.9]). In both sexes, after adjusting for age, large artery atherosclerosis was associated with SR (hazard ratio, 3.22 [95% CI, 1.42-7.24] and hazard ratio, 2.00 [95% CI, 1.14-3.51]). In a Kaplan-Meier analysis, females with positive diffusion-weighted imaging (P=0.014) and definitive TIA (log-rank test P=0.022) had a significantly higher risk of SR. CONCLUSIONS: Despite similar risks of SR, there were sex-related differences in baseline characteristics, presenting symptoms, patterns of acute ischemic lesions, cause, and outcomes. These findings encourage further research into optimal preventive strategies that take into account these differences.
BACKGROUND AND PURPOSE: Differences in sex in the incidence, presentation, and outcome of events after ischemic stroke have been studied in depth. In contrast, only limited data are available after transient ischemic attack (TIA). We aim to assess sex-related differences in the presentation, cause, neuroimaging features, and predictors of long-term prognosis in patients with TIA. METHODS: We carried out a prospective cohort study of consecutive patients with TIA from January 2006 to June 2010. Nondefinitive TIA events were defined by the presence of isolated atypical symptoms. The risk of stroke recurrence (SR) and composite of major vascular events were stratified by sex after a median follow-up time of 6.5 (interquartile range, 5.0-9.6) years. RESULTS: Among the 723 patients studied, 302 (41.8%) were female and 79 (10.9%) suffered a nondefinitive TIA event. Vascular territory diffusion-weighted imaging patterns (odds ratio, 1.61 [95% CI, 0.94-2.77]), and nondefinitive TIA events (odds ratio, 2.66 [95% CI, 1.55-4.59]) were associated with women, whereas active smoking (odds ratio, 0.30 [95% CI, 0.15-0.58]) and large artery atherosclerosis causes (odds ratio, 0.50 [95% CI, 0.29-0.83]) were related to men. The risk of SR was similar in both sexes (12.6% [95% CI, 8.9-16.3] for women versus 14.3% [95% CI, 11.0-17.6] for men). In contrast, the risk of major vascular events was significantly lower in women than in men (17.5% [95% CI, 13.2-21.8] versus 23.8% [95% CI, 19.7-27.9]). In both sexes, after adjusting for age, large artery atherosclerosis was associated with SR (hazard ratio, 3.22 [95% CI, 1.42-7.24] and hazard ratio, 2.00 [95% CI, 1.14-3.51]). In a Kaplan-Meier analysis, females with positive diffusion-weighted imaging (P=0.014) and definitive TIA (log-rank test P=0.022) had a significantly higher risk of SR. CONCLUSIONS: Despite similar risks of SR, there were sex-related differences in baseline characteristics, presenting symptoms, patterns of acute ischemic lesions, cause, and outcomes. These findings encourage further research into optimal preventive strategies that take into account these differences.
Authors: Francisco Purroy; Ana Vena; Carles Forné; Ana María de Arce; Antonio Dávalos; Blanca Fuentes; Juan Francisco Arenillas; Jerzy Krupinski; Manuel Gómez-Choco; Ernest Palomeras; Joan Martí-Fábregas; José Castillo; Xavier Ustrell; Javier Tejada; Jaime Masjuan; Moisés Garcés; Ikram Benabdelhak; Joaquin Serena Journal: Cerebrovasc Dis Date: 2019-05-03 Impact factor: 2.762
Authors: Francisco Purroy; Pedro Enrique Jiménez Caballero; Arantza Gorospe; María José Torres; José Alvarez-Sabin; Estevo Santamarina; Patricia Martínez-Sánchez; David Cánovas; María José Freijo; Jose Antonio Egido; Jose M Ramírez-Moreno; Arantza Alonso-Arias; Ana Rodríguez-Campello; Ignacio Casado; Raquel Delgado-Mederos; Joan Martí-Fàbregas; Blanca Fuentes; Yolanda Silva; Helena Quesada; Pere Cardona; Ana Morales; Natalia Pérez de la Ossa; Antonio García-Pastor; Juan F Arenillas; Tomas Segura; Carmen Jiménez; Jaime Masjuán Journal: J Neurol Neurosurg Psychiatry Date: 2013-01-23 Impact factor: 10.154
Authors: S Claiborne Johnston; Peter M Rothwell; Mai N Nguyen-Huynh; Matthew F Giles; Jacob S Elkins; Allan L Bernstein; Stephen Sidney Journal: Lancet Date: 2007-01-27 Impact factor: 79.321
Authors: Francisco Purroy; Mikel Vicente-Pascual; Gloria Arque; Robert Begue; Joan Farre; Yhovany Gallego; Maria Pilar Gil-Villar; Gerard Mauri; Nuria Montalà; Cristina Pereira; Coral Torres-Querol; Daniel Vazquez-Justes Journal: Front Neurol Date: 2022-07-14 Impact factor: 4.086