J Korean Med Sci.  2022 Aug;37(33):e254. 10.3346/jkms.2022.37.e254.

Risk of Subsequent Events in Patients With Minor Ischemic Stroke or HighRisk Transient Ischemic Attack

Affiliations
  • 1Department of Neurology, Korea University Guro Hospital, Seoul, Korea
  • 2Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Korea
  • 3Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 4Department of Neurology and Cerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
  • 5Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
  • 6Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
  • 7Department of Neurology, Seoul Medical Center, Seoul, Korea
  • 8Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Korea
  • 9Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
  • 10Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, Anyang, Korea
  • 11Department of Neurology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
  • 12Department of Neurology, Yeungnam University Medical Center, Daegu, Korea
  • 13Department of Neurology, Dong-A University Hospital, Busan, Korea
  • 14Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
  • 15Department of Neurology, Jeju National University Hospital, Jeju, Korea
  • 16AstraZeneca, Gothenburg, Sweden
  • 17AstraZeneca, Cambridge, UK
  • 18Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
  • 19BK21 FOUR Program in Learning Health Systems, Korea University, Seoul, Korea
  • 20Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

This study aimed to present the prognosis after minor acute ischemic stroke (AIS) or transient ischemic attack (TIA), using a definition of subsequent stroke in accordance with recent clinical trials. In total, 9,506 patients with minor AIS (National Institutes of Health Stroke Scale ≤ 5) or high-risk TIA (acute lesions or ≥ 50% cerebral artery steno-occlusion) admitted between November 2010 and October 2013 were included. The primary outcome was the composite of stroke (progression of initial event or a subsequent event) and all-cause mortality. The cumulative incidence of stroke or death was 11.2% at 1 month, 13.3% at 3 months and 16.7% at 1 year. Incidence rate of stroke or death in the first month was 12.5 per 100 person-months: highest in patients with large artery atherosclerosis (17.0). The risk of subsequent events shortly after a minor AIS or high-risk TIA was substantial, particularly in patients with large artery atherosclerosis.

Keyword

Minor Ischemic Stroke; Ischemic Attack; Transient; Event Outcome; Stroke Recurrence

Figure

  • Fig. 1 Adjusteda cumulative incidence of stroke or death (as composite and assessed individually) after minor AIS and TIA.AIS = acute ischemic stroke, TIA = transient ischemic attack.aDirect adjusted cumulative incidence by Cox proportional hazard regression analysis. Variables adjusted are age, gender, smoking, history of coronary heart disease, history of transient ischemic attack, history of stroke, history of hypertension, history of diabetes mellitus, history of dyslipidemia, history of atrial fibrillation and year of index date.


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