| Redefinition of Transient Ischemic Attack Improves Prognosis of Transient Ischemic Attack and Ischemic Stroke: An Example of the Will Rogers Phenomenon. | |
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MedLine Citation:
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PMID: 21921277 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: The recent redefinition of transient ischemic attack (TIA) reclassifies patients with acute infarction on magnetic resonance imaging as ischemic stroke. Redefinition will improve the prognosis of both TIA and ischemic stroke, an epidemiological paradox known as the Will Rogers phenomenon. We sought to quantify the impact of this phenomenon. METHODS: Incidence of TIA, risk of death/disability after stroke, rate of acute infarction on magnetic resonance imaging after TIA, and 90-day stroke risk after TIA with and without infarction on magnetic resonance imaging were determined based on published data. The impact on poststroke disability in the redefined cohort of patients with ischemic stroke was computed. A sensitivity analysis was performed to account for uncertainty in input variables. RESULTS: Using the new TIA definition, the 90-day risk of stroke following TIA is 1%. In the United States, redefinition will increase annual ischemic stroke incidence from 691 650 to 747 755 and result in a 3.4% absolute reduction in poststroke disability. In a sensitivity analysis, this risk reduction varies from 1.5 to 6.5%, and is most dependent on the incidence of TIA. CONCLUSIONS: Redefinition of TIA reduces stroke risk after TIA to approximately 1% at 90 days, and reduces the rate of poststroke disability by approximately 3.4%. |
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Authors:
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Michael T Mullen; Brett L Cucchiara |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-15 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: - ISSN: 1524-4628 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the University of Pennsylvania School of Medicine, Department of Neurology, Philadelphia, PA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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