Six-Month Outcome of Transient Ischemic Attack and Its Mimics
| Autor: | Nada El Andary, Neil Holland, Alia C Stanciu, Mihai Banciu, Ramin Zand, Vida Abedi, Alireza Sadighi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Ischemia 030204 cardiovascular system & hematology lcsh:RC346-429 Coronary artery disease 03 medical and health sciences 0302 clinical medicine DWI-negative transient ischemic attack Internal medicine parasitic diseases medicine Cumulative incidence cardiovascular diseases Stroke lcsh:Neurology. Diseases of the nervous system Original Research Intracerebral hemorrhage DWI-positive transient ischemic attack medicine.diagnostic_test business.industry composite outcome Magnetic resonance imaging follow-up study medicine.disease Confidence interval nervous system diseases Neurology Relative risk transient ischemic attack mimics Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Frontiers in Neurology, Vol 10 (2019) Frontiers in Neurology |
| ISSN: | 1664-2295 |
| DOI: | 10.3389/fneur.2019.00294 |
| Popis: | Background & Objective: Although the risk of recurrent cerebral ischemia is higher after a transient ischemic attack (TIA), there is limited data on the outcome of TIA mimics. The goal of this study is to compare the 6-month outcome of patients with negative and positive diffusion-weighted imaging (DWI) TIAs (DWI-neg TIA vs. DWI-pos TIA) and also TIA mimics. Methods: We prospectively studied consecutive patients with an initial diagnosis of TIA in our tertiary stroke centers in a two-year period. Every included patient had an initial magnetic resonance (MR) with DWI and one-month, three, and six-month follow-up visits. The primary outcome was defined as the composition of intracerebral hemorrhage, ischemic stroke, TIA, coronary artery disease, and death. Results: Out of 269 patients with the initial diagnosis of TIA, 259 patients (mean age 70.5 ± 15.0 [30-100] years old, 56.8% men) were included in the final analysis. 21 (8.1%, 95% confidence interval [CI] 5.1-12.1%) patients had a composite outcome event within the 6-month follow-up. Five (23.8%) and 13 (61.9%) composite outcome events occurred in the first 30 and 90 days, respectively. Among patients with DWI-neg TIA, the one-month and six-month ischemic stroke rate was 1.5% and 4.6%, respectively. The incidence proportion of composite outcome event was significantly higher among patients who had the diagnosis of DWI-neg TIA compared with those who had the diagnosis of TIA mimics (12.2% vs. 2.1% - relative risk 5.9; 95% CI, 1.4 - 25.2). In our univariable analysis among patients with DWI-neg TIA and DWI-pos TIA, age (P=0.017) was the only factor that was significantly associated with the occurrence of the composite outcome. Conclusion: Our study indicated that the overall six-month rate of the composite outcome among patients DWI-neg TIA, DWI-pos TIA, and TIA mimics were 12.2%, 9.7%, and 2.1%, respectively. Age was the only factor that was significantly associated with the occurrence of the composite outcome. |
| Databáze: | OpenAIRE |
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