Predictive implications of recurrent transient ischemic attacks in large-artery atherosclerosis.
BACKGROUND
It is uncertain whether recurrent transient ischemic attacks (R-TIAs), when comparing with single TIAs (S-TIAs), have any distinct mechanisms.


METHODS
All consecutive patients with TIAs, who had been admitted for a 2-year period, were divided into two groups: those who had R-TIAs and those who had S-TIAs. Registry data, medical records, and imaging findings were reviewed and compared between the two groups.


RESULTS
There were 85 patients who had TIAs: 42 patients had R-TIAs, and 43 patients had S-TIAs. On univariate analysis, R-TIA patients had less cardiac embolic TIA sources, less weakness, less speech disturbances, shorter symptom duration, a longer time interval from onset to treatment, less abnormalities on diffusion-weighted magnetic resonance imaging, and more significant relevant arterial stenoses. After logistic regression analysis, independent factors associated with R-TIAs were symptom duration < 10 min (odds ratio OR 3.62; 95% confidence interval CI 1.37-9.57), > or = 50% stenosis of the clinically relevant artery (OR 7.08; 95% CI 1.29-38.71), and absence of cardiac embolic sources (OR 0.04; 95% CI 0.002-0.71).


CONCLUSIONS
R-TIAs may have pathophysiological mechanisms distinct from those of S-TIAs and so may provide a clue for the etiologic diagnosis, in that patients with R-TIAs are more likely to have large-artery atherosclerosis.
Kim
Seo Hyun
SH
Department of Neurology, National Core Research Center for Nanomedical Technology, Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.
Han
Sang Won
SW
Heo
Ji Hoe
JH
D015901:Angiography, Digital Subtraction; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D004617:Embolism / Q000150:complications; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D014711:Vertebral Artery / Q000000981:diagnostic imaging; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging