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How predictors and patterns of stroke recurrence after a TIA differ during the first year of follow-up.

Abstract：

:The highest risk of subsequent stroke after a TIA occurs within the first week after the index event. However, the risk of stroke recurrence (SR) remains high during the first year of follow-up. We studied the temporal pattern and predictors of SR (at 7 days and from 7 days to 1-year follow-up). Between April 2008 and December 2009, we included 1,255 consecutive TIA patients from 30 Spanish stroke centers (PROMAPA study). We determined the short-term (at 7 days) and long-term (from 8 days to 1 year) risk of SR. Patients who underwent short-term recurrence and long-term recurrence were compared with regard to clinical findings, vascular territories, and etiology. Enough information (clinical variables and extracranial vascular imaging) was assessed in 1,137 (90.6 %) patients. The 7-day stroke risk was 2.6 %. 32 (3.0 %) patients had an SR after 7-day follow-up. Multiple TIA (HR 3.50, 1.67-7.35, p = 0.001) and large artery atherosclerosis (HR 2.51, 1.17-5.37, p = 0.018) were independent predictors of early SR, whereas previous stroke (HR 1.40, 1.03-1.92, p = 0.034) and coronary heart disease (2.65, 1.28-5.50, p = 0.009) were independent predictors of late SR. Notoriously, 80 % of SR happened in the same territory of the index TIA at 7-day follow-up, whereas only 38 % during the long-term follow-up (p < 0.001). Different predictors of SR were identified throughout the follow-up period. Moreover, the ischemic mechanism differed in early and late stroke recurrences.

journal_name

J Neurol

journal_title

Journal of neurology

authors

Purroy F,Jiménez Caballero PE,Gorospe A,Torres MJ,Alvarez-Sabin J,Martínez-Sánchez P,Cánovas D,Freijo M,Egido JA,Ramírez-Moreno JM,Alonso-Arias A,Rodríguez-Campello A,Casado-Naranjo I,Martí-Fàbregas J,Silva Y,Cardona P,Mo

doi

10.1007/s00415-014-7390-z

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

1614-21

issue

8

eissn

0340-5354

issn

1432-1459

journal_volume

261

pub_type

杂志文章

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