title: Incidence, predictors, and etiology of subsequent ischemic stroke within one year after transient ischemic attack.
abstract: Background Incidence and predictors of ischemic stroke in patients with transient ischemic attack (TIA) have not been fully clarified outside Europe and North America. Aims We undertook the present prospective, multicenter study to clarify the incidence, predictors, and etiology of ischemic stroke within one year of TIA onset in Japan. Methods The study subjects were patients within seven days of TIA onset who were enrolled in a prospective register from 57 hospitals between June 2011 and December 2013. The primary endpoint was occurrence of ischemic stroke. Results Of 1365 consecutive patients, 1245 were followed for one year after TIA onset; 101 (8.1%) experienced ischemic stroke during follow-up. The leading subtype of ischemic stroke was small-vessel occlusion (SVO) followed by large-artery atherosclerosis (LAA) attributable to intracranial artery diseases. When dividing ischemic stroke events between those occurring within the first 90 days after TIA onset and those occurring after the first 90 days, the leading subtype of ischemic stroke within the first 90 days after TIA onset was SVO, followed by LAA attributable to intracranial artery diseases. In comparison, the subtypes most commonly seen beyond the first 90 days after TIA onset were cardioembolic and LAA attributable to intracranial artery disease. The one-year risk of ischemic stroke increased significantly as ABCD2score increased, at 6.2% for 0-3 points, 7.2% for 4-5 points, and 11.6% for 6-7 points. Conclusions The one-year ischemic stroke risk after TIA was about 8% and was associated with the ABCD2score. The most common subtype of subsequent ischemic stroke was SVO.
authors.affiliation: 1 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Uehara
authors.affiliation: 1 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
authors.affiliation: 1 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ohara
authors.affiliation: 2 Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.affiliation: 3 Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
authors.affiliation: 4 Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: 5 Department of Neurology and Cerebrovascular Medicine, Saitama Medical University Saitama International Medical Center, Hidaka, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
authors.affiliation: 6 Department of Stroke Science, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: 7 Department of Neurology, Tokai University, Isehara, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Takagi
authors.affiliation: 8 Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan.
authors.forename: Jyoji
authors.initials: J
authors.lastname: Nakagawara
authors.affiliation: 9 Department of Neurology, Ebara Hospital, Tokyo, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Arii
authors.affiliation: 10 Department of Neurosurgery, Tokushima University, Tokushima, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Nagahiro
authors.affiliation: 11 Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.affiliation: 12 Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Uchiyama
authors.affiliation: 13 Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: 14 Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Iihara
authors.affiliation: 1 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*; D013997:Time Factors
keywords: Transient ischemic attack; intracranial artery disease; small-vessel occlusion; stroke