How predictors and patterns of stroke recurrence after a TIA differ during the first year of follow-up
| Autor: | Joan Martí-Fàbregas, María José Torres, Yolanda Silva, Carmen Jiménez, P. E. Jiménez Caballero, Ana Rodríguez-Campello, M. Freijo, Jaime Masjuan, Jose Antonio Egido, Juan F. Arenillas, Casado-Naranjo I, Tomás Segura, Francisco Purroy, Patricia Martínez-Sánchez, Pedro Cardona, Andrés García-Pastor, A. Alonso-Arias, David Cánovas, José M. Ramírez-Moreno, A. Gorospe, José Alvarez-Sabín, A. Morales |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Neurology Stroke recurrence Neuroimaging Kaplan-Meier Estimate Predictive Value of Tests Recurrence Risk Factors Internal medicine medicine Humans Transient ischemic attack Stroke Aged Proportional Hazards Models Retrospective Studies Outcome Neuroradiology Aged 80 and over Vascular imaging business.industry Large artery Middle Aged medicine.disease Coronary heart disease Surgery Stroke classification Echocardiography Ischemic Attack Transient Cardiology Etiology Female Neurology (clinical) business Follow-Up Studies |
| Zdroj: | JOURNAL OF NEUROLOGY r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-014-7390-z |
| Popis: | The highest risk of subsequent stroke after a TIA occurs within the first week after the index event. However, the risk of stroke recurrence (SR) remains high during the first year of follow-up. We studied the temporal pattern and predictors of SR (at 7 days and from 7 days to 1-year follow-up). Between April 2008 and December 2009, we included 1,255 consecutive TIA patients from 30 Spanish stroke centers (PROMAPA study). We determined the short-term (at 7 days) and long-term (from 8 days to 1 year) risk of SR. Patients who underwent short-term recurrence and long-term recurrence were compared with regard to clinical findings, vascular territories, and etiology. Enough information (clinical variables and extracranial vascular imaging) was assessed in 1,137 (90.6 %) patients. The 7-day stroke risk was 2.6 %. 32 (3.0 %) patients had an SR after 7-day follow-up. Multiple TIA (HR 3.50, 1.67-7.35, p = 0.001) and large artery atherosclerosis (HR 2.51, 1.17-5.37, p = 0.018) were independent predictors of early SR, whereas previous stroke (HR 1.40, 1.03-1.92, p = 0.034) and coronary heart disease (2.65, 1.28-5.50, p = 0.009) were independent predictors of late SR. Notoriously, 80 % of SR happened in the same territory of the index TIA at 7-day follow-up, whereas only 38 % during the long-term follow-up (p < 0.001). Different predictors of SR were identified throughout the follow-up period. Moreover, the ischemic mechanism differed in early and late stroke recurrences. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink