title: Transcranial Doppler ultrasonography predicts cardiovascular events after TIA.
abstract: BACKGROUND
  Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA.
  
  
  METHODS
  176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded.
  
  
  RESULTS
  22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial > or = 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001).
  
  
  CONCLUSIONS
  TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events.
authors: Department of Neurology, Klinikum rechts der Isar, Technische Universität, Munich, Germany. katrin.bruckmaier@gmx.de
authors: Katrin
authors: K
authors: Holzer
authors: Suwad
authors: S
authors: Sadikovic
authors: Lorena
authors: L
authors: Esposito
authors: Angelina
authors: A
authors: Bockelbrink
authors: Dirk
authors: D
authors: Sander
authors: Bernhard
authors: B
authors: Hemmer
authors: Holger
authors: H
authors: Poppert
mesh_terms: D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017585:Ultrasonography, Doppler, Transcranial / Q000706:statistics & numerical data*