Differential risks of subsequent vascular events for transient ischaemic attack and minor ischaemic stroke. |
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Authors: | Huey-Juan Lin Poh-Shiow Yeh Tsung-Chia Tsai Tain-Junn Cheng Dershin Ke Kao-Chang Lin Jih-Gong Ho Chia-Yu Chang |
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Affiliation: | Department of Neurology, Chi-Mei Medical Center, 901 Chung-Hwa Road, Yong-Kang, Tainan 710, Taiwan. huikuan@giga.net.tw |
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Abstract: | Using a prospective hospital-based registry, 146 patients with transient ischaemic attack (TIA) were compared with 376 patients with minor first-ever ischaemic stroke with respect to the 3-month risk of subsequent vascular events, in order to clarify the distinctions between the disease entities. All patients were enrolled within 48 h of onset. The risk factor distribution for the two groups was comparable, except that the TIA patients had more previous TIAs. Large artery atherosclerosis (34%) and small vessel occlusion (32%) were the main aetiologies in the TIA group, whereas small vessel occlusion (49%) was the major cause in the stroke group. The 3-month risk of combined endpoints of stroke, myocardial infarction, and vascular death for TIA patients was higher than that for the minor stroke group (15.1% vs. 3.2%; hazard ratio 4.6, 95% confidence interval 2.3-9.3 in multivariate analysis). Large artery atherosclerosis and male sex were the other significant predictors. TIA may demand more urgent management than minor stroke. The fact that aetiology is a predictor, highlights the need for rapid diagnostic tests to establish pathogenesis. |
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