title: Prediction of ischemic stroke in patients with tissue-defined transient ischemic attack.
abstract: BACKGROUND
  The risk of future stroke after transient ischemic attack (TIA) has been widely studied, but most findings were obtained for classically defined TIA (time-defined TIA). A new definition of TIA, that is, tissue-defined TIA, which requires the absence of fresh brain infarction on magnetic resonance imaging, could change stroke risk assessments. We, therefore, aimed to evaluate the risk of future stroke in patients with tissue-defined TIA.
  
  
  METHODS
  We retrospectively reviewed 74 patients with tissue-defined TIA, who could be followed for 2 years. Clinical, laboratory, and radiological data were collected and compared between groups that did and did not develop ischemic stroke within the 2-year period.
  
  
  RESULTS
  Ischemic stroke occurred in 11 patients (14.9%). Increased age, hemiparesis, and/or dysarthria during the TIA, old cerebral infarction revealed by magnetic resonance imaging, and large-artery stenosis detected by magnetic resonance angiography and/or ultrasonography tended to increase the risk of future stroke, but no individual factor showed statistically significant effect. TIA etiology did not significantly affect the risk. ABCD2 score, an established score for predicting stroke after time-defined TIA, showed only a weak association with future stroke. In contrast, new scores that we created reliably predicted future stroke; these included the APO (age, paresis, and old cerebral infarction) and APOL (age, paresis, old cerebral infarction, and large-artery stenosis) scores. The areas under the receiver operating characteristic curves were .662, .737, and .807 for ABCD2, APO, and APOL, respectively.
  
  
  CONCLUSIONS
  Compared with the established measures, our newly created scores could predict future stroke for tissue-defined TIA more reliably.
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan. Electronic address: thayashi@saitama-med.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kato
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Harumitsu
authors.initials: H
authors.lastname: Nagoya
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Ohe
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Deguchi
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukuoka
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Maruyama
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yohsuke
authors.initials: Y
authors.lastname: Horiuchi
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yuito
authors.initials: Y
authors.lastname: Nagamine
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Sano
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment; D020521:Stroke / Q000209:etiology* / Q000473:pathology
keywords: Clinical score; large-artery disease; old cerebral infarction; risk factor; stroke prediction; transient ischemic attack