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Transient Ischaemic Attack Rarely Precedes Stroke In A Cohort With Low Proportions Of Large Artery Atherosclerosis: A Population-Based Study

B. Giarola, James M Leyden, Sally Castle, J. Jannes, C. Anderson, J. Newbury, T. Kleinig
Published 2018 · Medicine

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Background: Ischaemic stroke is reportedly preceded by transient ischaemic attack (TIA) in 15–30% of all cases. The risk of stroke following TIA is highest in the presence of unstable atherosclerotic plaques in large arteries. The recent population-based Adelaide Stroke Incidence Study describes a population with a low proportion (16%) of stroke attributable to large artery atherosclerosis (LAA). We hypothesized that this population-based ischaemic stroke cohort would have a lower rate of preceding TIA than previously reported. Methods: This paper is a prospective ascertainment of all suspected TIAs and strokes in a 12-month period from 2009 to 2010. Ischaemic stroke pathogenesis was classified by the TOAST criteria. Details of preceding TIA events were scrutinised. Results: In this 12-month period, 318 stroke events in 301 individuals were recorded. Of the total 258 ischaemic strokes, 16% (95% confidence interval [CI] 12–22) were from LAA. Of 258 ischaemic stroke patients, only 11 (4%; 95% CI 2–7) reported symptoms in the preceding 90 days consistent with TIA. Nine (82%) sought medical attention. The median ABCD2 score in this group was 4.5 (IQR: 3–7), and the median time of event prior to stroke was 20 days (IQR: 4–32). Conclusion: In our population-based cohort, rates of TIA preceding ischaemic stroke were much lower than previously reported, probably reflective of effective secondary prevention (active TIA clinics) and primary prevention (limiting LAA prevalence). In our population, further enhancements in TIA care will be of limited yield.
This paper references
Warlow CP: Timing of TIAs preceding stroke: time window for prevention is very short
PM Rothwell (2005)
10.1001/ARCHNEUR.64.8.1105
Impact of abnormal diffusion-weighted imaging results on short-term outcome following transient ischemic attack.
S. Prabhakaran (2007)
10.1161/STROKEAHA.107.488833
Patterns and Predictors of Early Risk of Recurrence After Transient Ischemic Attack With Respect to Etiologic Subtypes
F. Purroy (2007)
10.1136/jnnp-2014-307856
Degree of blood pressure reduction and recurrent stroke: the PROGRESS trial
H. Arima (2014)
10.1212/01.WNL.0000152985.32732.EE
Timing of TIAs preceding stroke
P. Rothwell (2005)
Risk of TIA-Related Stroke Reflects Atherosclerosis www.karger.com/cee © 2018 The Author(s)
Giarola
10.1161/01.STR.24.1.35
Classification of Subtype of Acute Ischemic Stroke: Definitions for Use in a Multicenter Clinical Trial
H. Adams (1993)
10.1056/NEJMOA043033
Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis.
M. Chimowitz (2005)
10.1212/01.WNL.0000110311.09970.83
Early risk of recurrence by subtype of ischemic stroke in population-based incidence studies
J. Lovett (2004)
10.1136/bmj.b2083
Getting the priorities right for stroke care
C. Sudlow (2009)
10.1136/bmj.2.2701.905-a
Adelaide
Gerard Walschap (1912)
10.1016/j.jstrokecerebrovasdis.2013.12.001
Prediction of major vascular events after stroke: the stroke prevention by aggressive reduction in cholesterol levels trial.
B. Ovbiagele (2014)
Classification of Subtype of Acute Ischemic Stroke Definitions for Use in a Multicenter Clinical Trial
T. Carter (2005)
10.1016/S0140-6736(07)61448-2
Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison
P. Rothwell (2007)
10.1161/STROKEAHA.113.675140
Adelaide Stroke Incidence Study: Declining Stroke Rates but Many Preventable Cardioembolic Strokes
James M Leyden (2013)
10.1212/WNL.0b013e318242b419
Early Stroke Risk and Abcd2 Score Performance in Tissue- Vs Time-Defined Tia: A Multicenter Study
F. G. van Rooij (2012)
10.5694/J.1326-5377.2011.TB04196.X
Clinical predictive value of the ABCD2 score for early risk of stroke in patients who have had transient ischaemic attack and who present to an Australian tertiary hospital.
L. Sanders (2011)



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