1. One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke
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Amarenco, Pierre, Lavallée, Philippa C, Labreuche, Julien, Albers, Gregory W, Bornstein, Natan M, Canhão, Patrícia, Caplan, Louis R, Donnan, Geoffrey A, Ferro, José M, Hennerici, Michael G, Molina, Carlos, Rothwell, Peter M, Sissani, Leila, Skoloudík, David, Steg, Philippe Gabriel, Touboul, Pierre-Jean, Uchiyama, Shinichiro, Vicaut, Éric, Wong, Lawrence K S, Ameriso, Sebastian, Gandolfo, Claudia Nora, Povedano, Guillermo, Saggesse, Javier, Gandolfo, Claudia, Pavon, Heman, Cancino, Jorge, Toledo, Walter, Huang, Yinin, Gong, Xiping, Ma, Yetao, Mi, Donghu, Song, Tian, Wang, Yilong, Wang, Yongjun, Chandgfend, Fran, Congtao, Guo, Hongyun, Jiao, Intao, He, Jixing, Wu, Linlin, Liu, Liquing, Song, Liwen, Tai, Ran, Liu, Shujuan, Tian, Wenhong, Liu, Tsoi, Tak Hong, Wong, Lawrence, Liu, Roxanna, Flasar, Roman, Zítková, Bed?i?ka, Reif, Michal, Goldemund, David, Neumann, Ji?í, Svá?ková, Dagmar, a?ák, Daniel, Král, Michal, koloudík, David, Václavík, Daniel, Kuliha, Martin, Cabrejo, Lucie, Guidoux, Céline, Hobeanu, Cristina Maria, Lavallée, Philippa, Meseguer, Elena, Audebert, Henrich, Menger, Daniel, Heide, Wolfgang, Lipp, Saskia, Ozalp, Huriye, Sctzmann, Christine, Weimar, Christian, Platzbecker, Katharina, Ringleb, Peter, Hennerici, Michel G, Griebe, Martin, Willmann, Katrin Knoll Olaf, Faiss, Juergen harmut, Dillan, Susan, Kobersteein, Anja, Krimmer, Katharina, Tietz, Sandra, Wienecke, Peter, Hamann, Gerhard, Burkhardt, Nico, Liebetrau, Martin, Mueller, Nadine, Wagner, Michaela, Strivastava, Kelly, Peter, Merwick, Aline, Tanne, David, Cavazzuti, Milena, Anticoli, Sabrina, Toni, Danilo, Nagata, Ken, Okada, Yasushi, Yamagami, Hiroshi, Minematsu, Kazuo, Nakagawara, Jojo, Lee, Byung Chui, Yoon, Byung Woo, Hoe, Ji Hoe, Park, Jong Moo, Abboud, Halim, Koussa, Salam, Awada, Adnan, Tan, Kay Sin, Arauz, Antonio, Gongora, Fernando, Valenzuela, Adrian Infante, Escamilla, Juan M, Canhao, Patrica, Ferro, Jose, Fonseca, Ana Catarina, Correia, Manuel, Tuna, Assuncao, Sternic, Nada, Mijajlovic, Aleksandra Pavlovic Milija, Dupejova, Beata, Szedelyová, Jana, Smirkova, Renata, Segura, Tomas, Rodgriguez, Ana, Silva, Yolanda, Tejada, Javier, Purroy, Francisco, Masjuan, Jaime, Vivancos, Jose, Palomeras, Ernest, Gamemro, Miguel Angel, Arenillas, J F, Calleja, Anna, Rojo, Esther, Buchan, Alastair, Rothwell, Peter, Lee, Tsong Hai, Chang, Ku chou, Huang, Yu-Ching, Lin, Ruey-Tay, Tiamkao, Somsak, and the TIAregistry.org Investigators
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Male ,ABCD(2) SCORE ,Medizin ,Infarction ,030204 cardiovascular system & hematology ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Recurrence ,Risk Factors ,Stroke ,biology ,TIAregistry.org Investigators ,Ischemic Attack ,Transient ,Medicine (all) ,Composite outcomes ,Minor stroke ,General Medicine ,11 Medical And Health Sciences ,Middle Aged ,TIME ,Cardiovascular Diseases ,Ischemic Attack, Transient ,Female ,INFARCTION ,Life Sciences & Biomedicine ,Healthcare system ,Risk ,Acute coronary syndrome ,medicine.medical_specialty ,Aged ,Humans ,03 medical and health sciences ,Medicine, General & Internal ,General & Internal Medicine ,ABCD2 ,medicine ,cardiovascular diseases ,Science & Technology ,business.industry ,TIA ,medicine.disease ,RANDOMIZED-TRIAL ,INDIVIDUALS ,Emergency medicine ,biology.protein ,Physical therapy ,business ,030217 neurology & neurosurgery - Abstract
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.) Supported by an unrestricted grant from Sanofi and Bristol-Myers Squibb.