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Patients With Transient Ischemic Attack With ABCD2 <4 Can Have Similar 90-Day Stroke Risk as Patients With Transient Ischemic Attack With ABCD2 >=4.
MedLine Citation:
PMID:  22156685     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: It is unclear whether patients with transient ischemic attack with an ABCD(2) score <4 can be safely evaluated within the following week as recommended by some national guidelines rather than in emergency. METHODS: A total of 1679 patients in the SOS-TIA prospective cohort had a definite or possible transient ischemic attack and had complete information on ABCD(2) score components. They were evaluated and treated as soon as possible in a transient ischemic attack clinic with round-the-clock access, 87% of them within 24 hours of the first call to medical attention. Criteria for emergency treatment were internal carotid or intracranial artery stenosis ≥50% or major cardiac source of embolism. RESULTS: Primary end point was stroke at 90 days. The 90-day stroke rate (number of events/number of patients) was 3.4% (24/701) in patients with ABCD(2) score ≥4, 3.9% (7/180) in patients with ABCD(2) score <4 and criteria for emergency treatment, and 0.4% (3/798) in patients with ABCD(2) score <4 and no criteria for emergency treatment (P for between-group comparison <0.0001). CONCLUSIONS: When possible, patients with transient ischemic attack should be evaluated without delay regardless of ABCD(2) score because some with lower scores have treatable causes associated with higher short-term risks of stroke.
Authors:
Pierre Amarenco; Julien Labreuche; Philippa C Lavallée
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-8
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  -     ISSN:  1524-4628     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the INSERM U-698 and the Department of Neurology and Stroke Center, Paris-Diderot University, Bichat University Hospital, Paris, France.
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