title: Sex Differences in the Presentation, Care, and Outcomes of Transient Ischemic Attack: Results From the Ontario Stroke Registry.
abstract: OBJECTIVE
  Little is known about whether sex differences exist in the presentation, management, and outcomes of transient ischemic attack.
  
  
  METHODS
  We conducted a cohort study of 5991 consecutive patients with transient ischemic attack admitted to 11 stroke centers in Ontario, Canada, between July 1, 2003, and March 31, 2008 and compared presenting symptoms, processes of care, and outcomes in women and men. We used linkages to administrative databases to evaluate mortality and recurrent vascular events within 30 days and 1 year of the initial presentation, with multivariable analyses to assess whether sex differences persisted after adjustment for age and comorbid conditions.
  
  
  RESULTS
  The most common presenting symptoms for both sexes were weakness, speech impairment, and sensory deficit, with headache being slightly more frequent in women. Women were less likely than men to undergo carotid imaging, carotid endarterectomy, or receive lipid-lowering therapy. One-year mortality was slightly lower in women than in men (adjusted hazard ratio, 0.77; 95% confidence interval, 0.63-0.94).
  
  
  CONCLUSIONS
  We found only minor sex differences in the presentation and management of transient ischemic attack, suggesting that current public awareness campaigns focusing on classic warning signs are appropriate for both women and men. Future work should focus on evaluating whether lower rates of carotid imaging, endarterectomy, and lipid-lowering therapy in women reflect undertreatment of women or are appropriate based on patient eligibility.
authors.affiliation: From the Department of Medicine, University of Toronto, Ontario, Canada (O.L.L., F.L.S., R.S.W., M.K.K.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (J.L.); and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.L.S., J.F., M.S., M.K.K.).
authors.forename: Olivia L
authors.initials: OL
authors.lastname: Li
authors.affiliation: From the Department of Medicine, University of Toronto, Ontario, Canada (O.L.L., F.L.S., R.S.W., M.K.K.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (J.L.); and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.L.S., J.F., M.S., M.K.K.).
authors.forename: Frank L
authors.initials: FL
authors.lastname: Silver
authors.affiliation: From the Department of Medicine, University of Toronto, Ontario, Canada (O.L.L., F.L.S., R.S.W., M.K.K.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (J.L.); and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.L.S., J.F., M.S., M.K.K.).
authors.forename: Judith
authors.initials: J
authors.lastname: Lichtman
authors.affiliation: From the Department of Medicine, University of Toronto, Ontario, Canada (O.L.L., F.L.S., R.S.W., M.K.K.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (J.L.); and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.L.S., J.F., M.S., M.K.K.).
authors.forename: Jiming
authors.initials: J
authors.lastname: Fang
authors.affiliation: From the Department of Medicine, University of Toronto, Ontario, Canada (O.L.L., F.L.S., R.S.W., M.K.K.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (J.L.); and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.L.S., J.F., M.S., M.K.K.).
authors.forename: Melissa
authors.initials: M
authors.lastname: Stamplecoski
authors.affiliation: From the Department of Medicine, University of Toronto, Ontario, Canada (O.L.L., F.L.S., R.S.W., M.K.K.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (J.L.); and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.L.S., J.F., M.S., M.K.K.).
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Wengle
authors.affiliation: From the Department of Medicine, University of Toronto, Ontario, Canada (O.L.L., F.L.S., R.S.W., M.K.K.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (J.L.); and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.L.S., J.F., M.S., M.K.K.).
authors.forename: Moira K
authors.initials: MK
authors.lastname: Kapral
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D009026:Mortality / Q000639:trends; D009864:Ontario / Q000453:epidemiology; D012042:Registries; D012727:Sex Characteristics; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality*
keywords: ischemic attack, transient; registries; sex; stroke