TY - JOUR
T1 - Long-term stroke recurrence after transient ischemic attack
T2 - Implications of etiology
AU - Ois, Angel
AU - Cuadrado-Godia, Elisa
AU - Giralt-Steinhauer, Eva
AU - Jimenez-Conde, Jordi
AU - Soriano-Tarraga, Carolina
AU - Rodríguez-Campello, Ana
AU - Avellaneda, Carla
AU - Cascales, Diego
AU - Fernandez-Perez, Isabel
AU - Roquer, Jaume
N1 - Funding Information:
Supported in part by Spain’s Ministry of Health (Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III FEDER, RD12/0042/0020 INVICTUS-PLUS).
Funding Information:
Supported in part by Spain’s Ministry of Health (Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III FEDER, RD12/0042/0020 INVICTUS-PLUS). Elaine M. Lilly, PhD, provided English language assistance.
Publisher Copyright:
© 2019 Korean Stroke Society.
PY - 2019/5
Y1 - 2019/5
N2 - 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 one-point 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.
AB - 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 one-point 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.
KW - Ischemic attack
KW - Recurrence
KW - Stroke
KW - Transient
UR - http://www.scopus.com/inward/record.url?scp=85068900811&partnerID=8YFLogxK
U2 - 10.5853/jos.2018.03601
DO - 10.5853/jos.2018.03601
M3 - Article
C2 - 30991798
AN - SCOPUS:85068900811
VL - 21
SP - 184
EP - 189
JO - Journal of Stroke
JF - Journal of Stroke
SN - 2287-6391
IS - 2
ER -