Incidence and short-term prognosis of transient ischemic attack in a population-based study.
OBJECTIVE
Transient ischemic attacks (TIAs) have been shown to be a strong predictor of subsequent stroke and death. We present the incidence and short-term prognosis of TIA within a large population with a significant proportion of minorities with out-of-hospital TIA.


METHODS
TIA cases were identified between July 1, 1993 and June 30, 1994 from the Greater Cincinnati/Northern Kentucky population of 1.3 million inhabitants by previously published surveillance methods, including inpatient and out-of-hospital events. Incidence rates were adjusted to the 1990 population, and life-table analyses were used for prognosis.


RESULTS
The overall race, age, and gender-adjusted incidence rate for TIA within our population was 83 per 100,000, with age, race, and gender adjusted to the 1990 US population. Blacks and men had significantly higher rates of TIA than whites and women. Risk of stroke after TIA was 14.6% at 3 months, and risk of TIA/stroke/death was 25.2%. Age, race, and sex were not associated with recurrent TIA or subsequent stroke in our population, but age was associated with mortality.


CONCLUSIONS
Using our incidence rates for TIA in blacks and whites, we conservatively estimate that approximately 240 000 TIAs occurred in 2002 in the United States. Our incidence rate of TIA is slightly higher than previously reported, which may be related to the inclusion of blacks and out-of-hospital events. There are racial and gender-related differences in the incidence of TIA. We found a striking risk of adverse events after TIA; however, there were no racial or gender differences predicting these events. Further study is warranted in interventions to prevent these adverse events after TIA.
Kleindorfer
Dawn
D
Department of Emergency Medicine, University of Cincinnati, Ohio, USA. dawn.kleindorfer@uc.edu
Panagos
Peter
P
Pancioli
Arthur
A
Khoury
Jane
J
Kissela
Brett
B
Woo
Daniel
D
Schneider
Alexander
A
Alwell
Kathleen
K
Jauch
Edward
E
Miller
Rosie
R
Moomaw
Charles
C
Shukla
Rakesh
R
Broderick
Joseph P
JP
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D002561:Cerebrovascular Disorders / Q000175:diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012306:Risk; D012737:Sex Factors; D044465:White People