Long-Term Stroke Recurrence after Transient Ischemic Attack : Implications of Etiology
Autor: | Diego Cascales, Eva Giralt-Steinhauer, Isabel Fernandez-Perez, Jordi Jimenez-Conde, Carla Avellaneda, Carolina Soriano-Tárraga, Ana Rodríguez-Campello, Jaume Roquer, Angel Ois, Elisa Cuadrado-Godia |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Stroke recurrence 030204 cardiovascular system & hematology Ischemic attack transient 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Recurrence Internal medicine parasitic diseases medicine cardiovascular diseases Prospective cohort study Stroke business.industry Transient Ischemic attack medicine.disease Embolism lcsh:RC666-701 Cardiology Etiology Original Article Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
Zdroj: | Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona Journal of Stroke Journal of Stroke, Vol 21, Iss 2, Pp 184-189 (2019) |
Popis: | Background and purpose To analyze long-term stroke recurrence (SR) characteristics after transient ischemic attack (TIA) according to initial etiological classification. Methods A prospective cohort of 706 TIA patients was followed up in a single tertiary stroke center. Endpoint was SR. Etiologic subgroup was determined according to the evidence-based causative classification system. Location of TIA and SR was recorded as right, left, or posterior territory. Disability stroke recurrence (DSR) was defined as modified Rankin Scale (mRS) score >1 or a onepoint increase in those with previous mRS >1 at 3-month follow-up. Results During a follow-up of 3,493 patient-years (mean follow-up of 58.9±35.9 months), total SR was 125 (17.7%), corresponding to 3.6 recurrences per 100 patient-years. The etiology subgroups with a higher risk of SR were the unclassified (more than one cause) and large-artery atherosclerosis (LAA) categories. Of the SR cases, 88 (70.4%) had the same etiology as the index TIA; again, LAA etiology was the most frequent (83.9%). Notably, cardioaortic embolism was the most frequent cause (62.5%) of SR in the subgroup of 24 patients with undetermined TIA. Overall, SR occurred in the same territory in 74 of 125 patients (59.2%), with significant differences between etiological TIA subgroups (P=0.015). Eighty-two of 125 (65.6%) with SR had DSR, without differences between etiologies (P=0.453). Conclusions SR occurred mainly with the same etiology and location as initial TIA, although undetermined TIA was associated with a high proportion of cardioaortic embolism SR. More than half of the recurrences caused some disability, regardless of etiology. |
Databáze: | OpenAIRE |
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