One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke

Autor: Amarenco, Pierre, Lavallée, Philippa C, Labreuche, Julien, Albers, Gregory W, Bornstein, Natan M, Canhão, Patrícia, Caplan, Louis R, Donnan, Geoffrey A, Ferro, José M, Hennerici, Michael G, Molina, Carlos, Rothwell, Peter M, Sissani, Leila, Skoloudík, David, Steg, Philippe Gabriel, Touboul, Pierre-Jean, Uchiyama, Shinichiro, Vicaut, Éric, Wong, Lawrence K S, Ameriso, Sebastian, Gandolfo, Claudia Nora, Povedano, Guillermo, Saggesse, Javier, Gandolfo, Claudia, Pavon, Heman, Cancino, Jorge, Toledo, Walter, Huang, Yinin, Gong, Xiping, Ma, Yetao, Mi, Donghu, Song, Tian, Wang, Yilong, Wang, Yongjun, Chandgfend, Fran, Congtao, Guo, Hongyun, Jiao, Intao, He, Jixing, Wu, Linlin, Liu, Liquing, Song, Liwen, Tai, Ran, Liu, Shujuan, Tian, Wenhong, Liu, Tsoi, Tak Hong, Wong, Lawrence, Liu, Roxanna, Flasar, Roman, Zítková, Bed?i?ka, Reif, Michal, Goldemund, David, Neumann, Ji?í, Svá?ková, Dagmar, a?ák, Daniel, Král, Michal, koloudík, David, Václavík, Daniel, Kuliha, Martin, Cabrejo, Lucie, Guidoux, Céline, Hobeanu, Cristina Maria, Lavallée, Philippa, Meseguer, Elena, Audebert, Henrich, Menger, Daniel, Heide, Wolfgang, Lipp, Saskia, Ozalp, Huriye, Sctzmann, Christine, Weimar, Christian, Platzbecker, Katharina, Ringleb, Peter, Hennerici, Michel G, Griebe, Martin, Willmann, Katrin Knoll Olaf, Faiss, Juergen harmut, Dillan, Susan, Kobersteein, Anja, Krimmer, Katharina, Tietz, Sandra, Wienecke, Peter, Hamann, Gerhard, Burkhardt, Nico, Liebetrau, Martin, Mueller, Nadine, Wagner, Michaela, Strivastava, Kelly, Peter, Merwick, Aline, Tanne, David, Cavazzuti, Milena, Anticoli, Sabrina, Toni, Danilo, Nagata, Ken, Okada, Yasushi, Yamagami, Hiroshi, Minematsu, Kazuo, Nakagawara, Jojo, Lee, Byung Chui, Yoon, Byung Woo, Hoe, Ji Hoe, Park, Jong Moo, Abboud, Halim, Koussa, Salam, Awada, Adnan, Tan, Kay Sin, Arauz, Antonio, Gongora, Fernando, Valenzuela, Adrian Infante, Escamilla, Juan M, Canhao, Patrica, Ferro, Jose, Fonseca, Ana Catarina, Correia, Manuel, Tuna, Assuncao, Sternic, Nada, Mijajlovic, Aleksandra Pavlovic Milija, Dupejova, Beata, Szedelyová, Jana, Smirkova, Renata, Segura, Tomas, Rodgriguez, Ana, Silva, Yolanda, Tejada, Javier, Purroy, Francisco, Masjuan, Jaime, Vivancos, Jose, Palomeras, Ernest, Gamemro, Miguel Angel, Arenillas, J F, Calleja, Anna, Rojo, Esther, Buchan, Alastair, Rothwell, Peter, Lee, Tsong Hai, Chang, Ku chou, Huang, Yu-Ching, Lin, Ruey-Tay, Tiamkao, Somsak
Přispěvatelé: the TIAregistry.org Investigators
Předmět:
Male
ABCD(2) SCORE
Medizin
Infarction
030204 cardiovascular system & hematology
law.invention
0302 clinical medicine
Randomized controlled trial
law
Recurrence
Risk Factors
Stroke
biology
TIAregistry.org Investigators
Ischemic Attack
Transient
Medicine (all)
Composite outcomes
Minor stroke
General Medicine
11 Medical And Health Sciences
Middle Aged
TIME
Cardiovascular Diseases
Ischemic Attack
Transient

Female
INFARCTION
Life Sciences & Biomedicine
Healthcare system
Risk
Acute coronary syndrome
medicine.medical_specialty
Aged
Humans
03 medical and health sciences
Medicine
General & Internal

General & Internal Medicine
ABCD2
medicine
cardiovascular diseases
Science & Technology
business.industry
TIA
medicine.disease
RANDOMIZED-TRIAL
INDIVIDUALS
Emergency medicine
biology.protein
Physical therapy
business
030217 neurology & neurosurgery
Zdroj: Recercat. Dipósit de la Recerca de Catalunya
instname
Repositorio Abierto de la UdL
Universitad de Lleida
Popis: BACKGROUND Previous studies conducted between 1997 and 2003 estimated that the risk of stroke or an acute coronary syndrome was 12 to 20% during the first 3 months after a transient ischemic attack (TIA) or minor stroke. The TIAregistry.org project was designed to describe the contemporary profile, etiologic factors, and outcomes in patients with a TIA or minor ischemic stroke who receive care in health systems that now offer urgent evaluation by stroke specialists. METHODS We recruited patients who had had a TIA or minor stroke within the previous 7 days. Sites were selected if they had systems dedicated to urgent evaluation of patients with TIA. We estimated the 1-year risk of stroke and of the composite outcome of stroke, an acute coronary syndrome, or death from cardiovascular causes. We also examined the association of the ABCD2 score for the risk of stroke (range, 0 [lowest risk] to 7 [highest risk]), findings on brain imaging, and cause of TIA or minor stroke with the risk of recurrent stroke over a period of 1 year. RESULTS From 2009 through 2011, we enrolled 4789 patients at 61 sites in 21 countries. A total of 78.4% of the patients were evaluated by stroke specialists within 24 hours after symptom onset. A total of 33.4% of the patients had an acute brain infarction, 23.2% had at least one extracranial or intracranial stenosis of 50% or more, and 10.4% had atrial fibrillation. The Kaplan–Meier estimate of the 1-year event rate of the composite cardiovascular outcome was 6.2% (95% confidence interval, 5.5 to 7.0). Kaplan–Meier estimates of the stroke rate at days 2, 7, 30, 90, and 365 were 1.5%, 2.1%, 2.8%, 3.7%, and 5.1%, respectively. In multivariable analyses, multiple infarctions on brain imaging, large-artery atherosclerosis, and an ABCD2 score of 6 or 7 were each associated with more than a doubling of the risk of stroke. CONCLUSIONS We observed a lower risk of cardiovascular events after TIA than previously reported. The ABCD2 score, findings on brain imaging, and status with respect to large-artery atherosclerosis helped stratify the risk of recurrent stroke within 1 year after a TIA or minor stroke. (Funded by Sanofi and Bristol-Myers Squibb.) Supported by an unrestricted grant from Sanofi and Bristol-Myers Squibb.
Databáze: OpenAIRE