title: Epidemiology of Transient Ischemic Attacks Using Time- or Tissue-Based Definitions: A Population-Based Study.
abstract: Transient ischemic attack (TIA) epidemiology may have changed in recent years as a consequence of improved identification and treatment of vascular risk factors. Our aim was to provide updated information about TIA epidemiology in Italy.
  
  
  
  Cases of first-ever TIA were ascertained from January 1, 2011, until December 31, 2012, in a population-based prospective registry. All residents in the L'Aquila district with an incident TIA were included and followed up to 2 years after the event. Outcome events were recurrent TIA, nonfatal and fatal stroke, nonfatal and fatal myocardial infarction, and all-cause mortality.
  
  
  
  A total of 210 patients with a TIA according to the traditional time-based definition were included (51.4% women); 151 patients (71.9%) with transient symptoms and negative brain neuroimaging were broadly considered as tissue-based TIA, 29 patients (13.8%) had transient symptoms and evidence of a congruous acute ischemic lesion, and 30 patients (14.3%) had an acute neurovascular syndrome. The crude annual incidence rate for traditional time-based TIA was 35.2 per 100 000 (95% confidence interval, 30.6-40.3) and 28.6 per 100 000 (95% confidence interval, 24.1-33.5) when standardized to the 2011 European population. The incidence peaked in subjects aged ≥85 years, in both sexes. At 2 years, outcome events occurred in 50 patients (23.8%) including 15 patients (7.1%) with nonfatal or fatal strokes.
  
  
  
  Our population-based study found a low annual TIA incidence rate and a fair TIA prognosis confirming the effectiveness of preventive strategies for cardiovascular diseases. We also proved the nonfitting applicability of the tissue-based definition in our district.
authors.affiliation: From the Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Degan
authors.affiliation: From the Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ornello
authors.affiliation: From the Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy.
authors.forename: Cindy
authors.initials: C
authors.lastname: Tiseo
authors.affiliation: From the Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: De Santis
authors.affiliation: From the Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pistoia
authors.affiliation: From the Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy. antonio.carolei@univaq.it a_carolei@yahoo.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carolei
authors.affiliation: From the Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Sacco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D055815:Young Adult
keywords: cerebrovascular disease; epidemiology; incidence; stroke; transient ischemic attack