Stroke Risk Is Low after Urgently Treated Transient Ischemic Attack

J Stroke Cerebrovasc Dis. 2018 Feb;27(2):291-295. doi: 10.1016/j.jstrokecerebrovasdis.2017.08.037. Epub 2017 Nov 3.

Abstract

Background: Over the last decades, the approach to patients with transient ischemic attack (TIA) has shifted from treating only patients considered at high risk of recurrent stroke, to referring all patients with TIA to urgent assessment and immediate initiation of preventive treatment. The data on how this change has influenced the stroke rate after TIA are limited. Thus, the primary aim of this study was to identify the incidence of stroke recurrence after TIA. Second, we wanted to evaluate the ABCD2 score as a predictor of recurrent stroke.

Methods: Patients discharged with a diagnosis of TIA from the Stroke Unit at Akershus University Hospital between January 1, 2013 and December 31, 2013 were included in the study. Data were obtained from the electronic medical records. Readmission data to capture recurrent strokes were registered until December 31, 2015.

Results: In total, 261 patients were included. Mean age was 70.7 years. Stroke incidence at 1 month, 1 year, and the end of follow-up was 1.5% (n = 4), 3.4% (n = 9), and 4.2% (n = 11), respectively. Median time from TIA until recurrent stroke was 90 days. The ability of the ABCD2 score to predict recurrent stroke was low.

Conclusions: Urgent admission of patients with TIA is followed by a very low risk of early and late recurrent stroke. The ABCD2 score did not identify patients at high risk of recurrent stroke.

Keywords: Ischemic attack; cerebrovascular diseases; emergency; recurrent stroke; transient.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Decision Support Techniques
  • Electronic Health Records
  • Female
  • Hospitals, University
  • Humans
  • Incidence
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / drug therapy*
  • Ischemic Attack, Transient / epidemiology
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Patient Readmission
  • Predictive Value of Tests
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / drug therapy*
  • Stroke / epidemiology
  • Thrombolytic Therapy* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Young Adult