title: Prior transient ischemic attack is independently associated with lesser in-hospital case fatality in acute stroke.
abstract: OBJECTIVE
  Ischemic preconditioning has been well established in healthy human hearts, but limited information is available about its occurrence or its integrity in the brain. The aim of the present study was therefore to investigate whether a prior cerebral ischemic episode (stroke or transient ischemic attack [TIA]) is able to confer protection against ischemic stroke, reflected by in-hospital case fatality.
  
  
  METHODS
  A total of 2874 acute stroke patients included in the prospective, hospital-based Debrecen Stroke Database were studied, of whom 673 had previous stroke and 195 had prior TIA.
  
  
  RESULTS
  Following adjustment for active confounders, TIA but not stroke in the history was associated with decreased odds for in-hospital case fatality (odds ratio, 0.53; 95% confidence interval: 0.29-0.98; P = 0.041). The fitness of the final multiple regression model was good (Hosmer-Lemeshow goodness-of-fit chi(2) statistic (P = 0.328).
  
  
  CONCLUSIONS
  TIA may have an ischemic preconditioning effect in the human brain.
authors.affiliation: Department of Neurology, University of Debrecen, Hungary. zsuga@king.pharmacol.dote.hu
authors.forename: Judit
authors.initials: J
authors.lastname: Zsuga
authors.forename: Rudolf
authors.initials: R
authors.lastname: Gesztelyi
authors.forename: Bela
authors.initials: B
authors.lastname: Juhasz
authors.forename: Adam
authors.initials: A
authors.lastname: Kemeny-Beke
authors.forename: Istvan
authors.initials: I
authors.lastname: Fekete
authors.forename: Laszlo
authors.initials: L
authors.lastname: Csiba
authors.forename: Daniel
authors.initials: D
authors.lastname: Bereczki
mesh_terms: D000208:Acute Disease; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000401:mortality; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology*; D019194:Ischemic Preconditioning; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000401:mortality; D020521:Stroke / Q000150:complications / Q000209:etiology / Q000401:mortality*