[Clinical factors predicting the appearance of vascular events following a transient ischemic attack].
BACKGROUND
Patients who have suffered a transient ischemic attack (TIA) have a high risk of undergoing a severe vascular event. Most of them do not receive early attention and cannot benefit from an adequate diagnosis and treatment.


OBJECTIVE
The aim of this study is to identify the clinical factors that predict the appearance of a new vascular event in these patients.


METHODS
We conducted a prospective study of 104 TIA patients, who had been given attention during the first 24 hours after the onset of symptoms, for a mean follow up time of 12.6 months.


RESULTS
The incidence rates of strokes, ischemic heart disease, peripheral arteriopathy and death were 13, 6, 3 and 8%, respectively. Multivariate analysis identified the following aspects as independent predictors of new strokes: an age above 73 odds ratio (OR) 4.46 (CI 95%, 1.15 17.38) and an atherothrombotic aetiology OR 4.36 (CI 95%, 1.4413.18); and episodes of ischemic heart disease, a history of suffering from such heart disease OR 30.65 (CI 95%, 2.94319.17) and taking oral antidiabetic drugs OR 31.23 (CI 95%, 2.65368.74). Leukocytosis OR 11.21 (CI 95%, 1.25100.39) is linked to the deaths caused by vascular disorders, whereas an atherothrombotic aetiology OR 3.83 (CI 95%, 1.31 11.20) and being male OR 3.44 (CI 95%, 1.02 11.60) were seen to be predictors of the appearance of any vascular event.


CONCLUSIONS
Our findings showed that the risk of suffering severe vascular events after a TIA becomes higher. There are a number of useful clinical variables (age above 73, atherothrombotic aetiology, being male, taking oral antidiabetic drugs and leukocytosis) for identifying the patients at the highest risk.
Purroy García
F
F
Hospital General Universitari Vall d Hebron, Barcelona, España. 34271fpg@comb.es
Montaner
J
J
Delgado
P
P
Ribó
M
M
Arenillas Lara
J F
JF
Quintana
M
M
Alvarez Sabín
J
J
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000517:prevention & control; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control; D014652:Vascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control
D007004:Hypoglycemic Agents