Document Detail


Long-term mortality and risk of stroke after transient ischemic attack: a hospital-based cohort study.
MedLine Citation:
PMID:  19373427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Stroke and mortality rates in patients with transient ischemic attack (TIA) differ widely between community-based studies and research cohorts. Our aim therefore was to provide a reliable estimate for TIA patients treated in German neurology departments with an acute stroke unit. METHODS: A total of 1951 consecutively admitted TIA patients were prospectively documented in 13 centers and 1480 (75.9%) gave consent for long-term follow-up. During a mean follow-up of 23.4 months, we assessed recurrent cerebrovascular events and cause of death in 1448 patients via standardized telephone interview including confirmation of endpoint events by the treating physician. RESULTS: Overall 94 patients (6.5%) suffered a stroke and 118 patients (8.1%) died, 21 due to stroke. The Kaplan-Meier estimate for stroke during the first year was 4.4% (95% CI 3.2-5.6%) which corresponds to a relative risk of 9.5 (95% CI 7.4-12.3) compared to the population-based stroke incidence in Germany. The annual rates after the first year were 2.2% (95% CI 1.7-2.7%) for stroke and 3.2% (95% CI 2.7-3.8%) for death. Independent predictors for stroke during follow-up were age and previous cerebrovascular events. The ABCD(2) score did not provide any meaningful prediction of stroke risk at 90 days. CONCLUSION: While the in-hospital risk of stroke was low, long-term stroke rates in our well-defined multicenter hospital-based cohort were comparable to a large randomized trial. In patients with a well-established diagnosis of TIA, only age and previous cerebrovascular events seem to constitute independent predictors for stroke during long-term follow-up.
Authors:
Christian Weimar; Jens Benemann; Roman Huber; Thomas Mieck; Stephen Kaendler; Steven Grieshammer; Zaza Katsarava; Hans-Christoph Diener;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-04-15
Journal Detail:
Title:  Journal of neurology     Volume:  256     ISSN:  1432-1459     ISO Abbreviation:  J. Neurol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-05-15     Completed Date:  2009-08-20     Revised Date:  2009-10-14    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  639-44     Citation Subset:  IM    
Affiliation:
Dept. of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany. stroke.med@uni-essen.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Female
Follow-Up Studies
Humans
Incidence
Ischemic Attack, Transient / epidemiology,  mortality*
Kaplan-Meiers Estimate
Male
Middle Aged
Recurrence
Risk
Risk Factors
Stroke / epidemiology,  mortality*
Young Adult
Investigator
Investigator/Affiliation:
M Heyden / ; M Müller / ; C Hagemeister / ; K Luckner / ; C Weimar / ; C Fritzsch / ; A Khaw / ; K Weissenborn / ; S Kaendler / ; C Terborg / ; U Frost / ; D Michalski / ; C Röhrig / ; M Goertler / ; G Zindler / ; A Kloth / ; T Mieck / ; R Huber / ; S Grieshammer /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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