Predictors of major vascular events in patients with a transient ischemic attack or nondisabling stroke. The Dutch TIA Trial Study Group.
OBJECTIVE
Very few studies have addressed the identification of prognostic factors in patients with a transient ischemic attack or minor stroke.


METHODS
We prospectively studied the prognostic value of clinical, laboratory, radiological, and electrocardiographic findings in 997 patients with a transient ischemic attack and 2,130 patients with a minor stroke who were entered into a multicenter clinical trial. The mean follow-up period was 2.6 years.


RESULTS
A total of 302 patients died (212 from a vascular cause), 272 had a stroke, and 200 had a cardiac event. By means of a multivariate analysis we identified the following independent risk factors for stroke, myocardial infarction, or vascular death: age of > 65 years; male sex; dysarthria; multiple attacks; diabetes; angina pectoris; intermittent claudication; computed tomographic evidence of any cerebral infarct, especially a border zone infarct or white matter hypodensity; and electrocardiographic evidence of an anteroseptal infarct, ST depression, left ventricular hypertrophy, or left atrial conduction delay. Protective predictors were monocular attacks only or the presence of rotatory dizziness.


CONCLUSIONS
A limited number of easily obtainable characteristics are powerful predictors of major vascular events in patients with cerebral ischemia.
D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications*; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D014652:Vascular Diseases / Q000209:etiology* / Q000401:mortality