Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services
- PMID: 14744823
- PMCID: PMC338101
- DOI: 10.1136/bmj.37991.635266.44
Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services
Abstract
Objective: To estimate the very early stroke risk after a transient ischaemic attack (TIA) or minor stroke and thereby inform the planning of effective stroke prevention services.
Design: Population based prospective cohort study of patients with TIA or stroke.
Setting: Nine general practices in Oxfordshire, England, from April 2002 to April 2003.
Participants: All patients who had a TIA (n = 87) or minor stroke (n = 87) during the study period and who presented to medical attention.
Main outcome measures: Risk of recurrent stroke at seven days, one month, and three months after TIAs and minor strokes.
Results: The estimated risk of recurrent stroke was 8.0% (95% confidence interval 2.3% to 13.7%) at seven days, 11.5% (4.8% to 18.2%) at one month, and 17.3% (9.3% to 25.3%) at three months after a TIA. The risks at these three time periods after a minor stroke were 11.5% (4.8% to 11.2%), 15.0% (7.5% to 22.5%), and 18.5% (10.3% to 26.7%).
Conclusions: The early risks of stroke after a TIA or minor stroke are much higher than commonly quoted. More research is needed to determine whether these risks can be reduced by more rapid instigation of preventive treatment.
Figures
Similar articles
-
Medical Attention Seeking After Transient Ischemic Attack and Minor Stroke Before and After the UK Face, Arm, Speech, Time (FAST) Public Education Campaign: Results From the Oxford Vascular Study.JAMA Neurol. 2018 Oct 1;75(10):1225-1233. doi: 10.1001/jamaneurol.2018.1603. JAMA Neurol. 2018. PMID: 29971433 Free PMC article.
-
Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison.Lancet. 2007 Oct 20;370(9596):1432-42. doi: 10.1016/S0140-6736(07)61448-2. Lancet. 2007. PMID: 17928046
-
The Alberta Stroke Prevention in TIAs and mild strokes (ASPIRE) intervention: rationale and design for evaluating the implementation of a province-wide TIA triaging system.Int J Stroke. 2014 Oct;9 Suppl A100:135-43. doi: 10.1111/j.1747-4949.2012.00881.x. Epub 2012 Oct 23. Int J Stroke. 2014. PMID: 23088263
-
Prognosis of vertebrobasilar transient ischaemic attack and minor stroke.Brain. 2003 Sep;126(Pt 9):1940-54. doi: 10.1093/brain/awg197. Epub 2003 Jul 7. Brain. 2003. PMID: 12847074 Review.
-
Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis.Lancet Neurol. 2007 Dec;6(12):1063-72. doi: 10.1016/S1474-4422(07)70274-0. Epub 2007 Nov 13. Lancet Neurol. 2007. PMID: 17993293 Review.
Cited by
-
Clinical and cost-effectiveness of clopidogrel resistance genotype testing after ischaemic stroke or transient ischaemic attack: a systematic review and economic model.Health Technol Assess. 2024 Sep;28(57):1-194. doi: 10.3310/PWCB4016. Health Technol Assess. 2024. PMID: 39269241 Free PMC article.
-
Brazilian Angiology and Vascular Surgery Society Guidelines for the treatment of extracranial cerebrovascular disease.J Vasc Bras. 2024 May 31;23:e20230094. doi: 10.1590/1677-5449.202300942. eCollection 2024. J Vasc Bras. 2024. PMID: 39099701 Free PMC article.
-
Stem cell-derived extracellular vesicles in the therapeutic intervention of Alzheimer's Disease, Parkinson's Disease, and stroke.Theranostics. 2024 May 27;14(8):3358-3384. doi: 10.7150/thno.95953. eCollection 2024. Theranostics. 2024. PMID: 38855176 Free PMC article. Review.
-
Comparison of Effectiveness and Safety of Dual Antiplatelet Therapy (DAPT) With Clopidogrel and Aspirin Versus Aspirin Monotherapy in Patients With Mild-to-Moderate Stroke and Transient Ischemic Attack: A Systematic Review and Meta-Analysis.Cureus. 2024 Apr 24;16(4):e58909. doi: 10.7759/cureus.58909. eCollection 2024 Apr. Cureus. 2024. PMID: 38800328 Free PMC article. Review.
-
Characteristics and risk of stroke in emergency department patients with acute dizziness.Heliyon. 2024 May 9;10(10):e30953. doi: 10.1016/j.heliyon.2024.e30953. eCollection 2024 May 30. Heliyon. 2024. PMID: 38770312 Free PMC article.
References
-
- Hankey GJ. Impact of treatment of people with transient ischaemic attack on stroke incidence and public health. Cerebrovasc Dis 1996;6(suppl 1): 26-33.
-
- Intercollegiate Working Party for Stroke. National clinical guidelines for stroke. London: Royal College of Physicians, 2000.
-
- Scottish Intercollegiate Guidelines Network. SIGN guidelines: management of patients with stroke. Edinburgh: SIGN, 1997.
-
- Department of Health. National service framework for older people. London: Department of Health, 2001.
-
- Evenson KR, Rosamond WD, Morris DL. Prehospital and in-hospital delays in acute stroke care. Neuroepidemiology 2001;20: 65-76. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous