Differential risks of subsequent vascular events for transient ischaemic attack and minor ischaemic stroke.
Using a prospective hospital-based registry, 146 patients with transient ischaemic attack (TIA) were compared with 376 patients with minor first-ever ischaemic stroke with respect to the 3-month risk of subsequent vascular events, in order to clarify the distinctions between the disease entities. All patients were enrolled within 48 h of onset. The risk factor distribution for the two groups was comparable, except that the TIA patients had more previous TIAs. Large artery atherosclerosis (34%) and small vessel occlusion (32%) were the main aetiologies in the TIA group, whereas small vessel occlusion (49%) was the major cause in the stroke group. The 3-month risk of combined endpoints of stroke, myocardial infarction, and vascular death for TIA patients was higher than that for the minor stroke group (15.1% vs. 3.2%; hazard ratio 4.6, 95% confidence interval 2.3-9.3 in multivariate analysis). Large artery atherosclerosis and male sex were the other significant predictors. TIA may demand more urgent management than minor stroke. The fact that aetiology is a predictor, highlights the need for rapid diagnostic tests to establish pathogenesis.
Lin
Huey-Juan
HJ
Department of Neurology, Chi-Mei Medical Center, 901 Chung-Hwa Road, Yong-Kang, Tainan 710, Taiwan. huikuan@giga.net.tw
Yeh
Poh-Shiow
PS
Tsai
Tsung-Chia
TC
Cheng
Tain-Junn
TJ
Ke
Dershin
D
Lin
Kao-Chang
KC
Ho
Jih-Gong
JG
Chang
Chia-Yu
CY
D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011379:Prognosis; D012306:Risk; D020521:Stroke / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology