title: Short- and Long-Term Stroke Risk after Urgent Management of Transient Ischaemic Attack: The Bologna TIA Clinical Pathway.
abstract: BACKGROUND
  Rapid management can reduce the short stroke risk after transient ischaemic attack (TIA), but the long-term effect is still little known. We evaluated 3-year vascular outcomes in patients with TIA after urgent care.
  
  
  METHODS
  We prospectively enrolled all consecutive patients with TIA diagnosed by a vascular neurologist and referred to our emergency department (ED). Expedited assessment and best secondary prevention was within 24 h. Endpoints were stroke within 90 days, and stroke, myocardial infarction, and vascular death at 12, 24 and 36 months.
  
  
  RESULTS
  Between August 2010 and July 2013, we evaluated 686 patients with suspected TIA; 433 (63%) patients had confirmed TIA. Stroke at 90 days was 2.07% (95% confidence interval (CI), 1.1-3.9) compared with the ABCD2-predicted risk of 9.1%. The long-term stroke risk was 2.6% (95% CI, 1.1-4.2), 3.7% (95% CI, 1.6-5.9) and 4.4% (95% CI, 1.9-6.8) at 12, 24 and 36 months, respectively. The composite outcome of stroke, myocardial infarction, and vascular death was 3.5% (95% CI, 1.7-5.1), 4.9% (95% CI, 2.5-7.4), and 5.6% (95% CI, 2.8-8.3) at 12, 24, and 36 months, respectively.
  
  
  CONCLUSIONS
  TIA expedited management driven by vascular neurologists was associated with a marked reduction in the expected early stroke risk and low long-term risk of stroke and other vascular events.
authors.affiliation: Neurology Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Guarino
authors.forename: Francesca
authors.initials: F
authors.lastname: Rondelli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Favaretto
authors.forename: Andrea
authors.initials: A
authors.lastname: Stracciari
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippini
authors.forename: Rita
authors.initials: R
authors.lastname: Rinaldi
authors.forename: Ivana
authors.initials: I
authors.lastname: Zele
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Sartori
authors.forename: Gianluca
authors.initials: G
authors.lastname: Faggioli
authors.forename: Susanna
authors.initials: S
authors.lastname: Mondini
authors.forename: Andrea
authors.initials: A
authors.lastname: Donti
authors.forename: Enrico
authors.initials: E
authors.lastname: Strocchi
authors.forename: Daniela
authors.initials: D
authors.lastname: Degli Esposti
authors.forename: Antonio
authors.initials: A
authors.lastname: Muscari
authors.forename: Maddalena
authors.initials: M
authors.lastname: Veronesi
authors.forename: Sergio
authors.initials: S
authors.lastname: D'Addato
authors.forename: Luca
authors.initials: L
authors.lastname: Spinardi
authors.forename: Luca
authors.initials: L
authors.lastname: Faccioli
authors.forename: Marco
authors.initials: M
authors.lastname: Pastore Trossello
authors.forename: Fabio
authors.initials: F
authors.lastname: Cirignotta
mesh_terms: D000368:Aged; D019091:Critical Pathways; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors