Prognosis of transient ischemic attacks in the Oxfordshire Community Stroke Project

Stroke. 1990 Jun;21(6):848-53. doi: 10.1161/01.str.21.6.848.

Abstract

In a community-based study of approximately 105,000 people, 184 presented with a transient ischemic attack during the 5 years between 1981 and 1986; we believe these persons represent almost all new cases of transient ischemic attack going to a doctor during that period. During a mean follow-up of 3.7 years 49 patients died, 45 had a first-ever stroke, and 17 had a myocardial infarction. Cardiac disease accounted for 17 (35%) deaths, while stroke was the cause of death in 15 patients (31%). The average actuarial risk of death was approximately 6.3%/yr, slightly greater than that expected for similar people without transient ischemic attacks (risk ratio [observed divided by expected] = 1.4). The actuarial risk of stroke was 11.6% during the first year after a transient ischemic attack and approximately 5.9%/yr over the first 5 years. Patients who suffered a transient ischemic attack had a 13-fold excess risk of stroke during the first year and a sevenfold excess risk over the first 7 years compared with people without transient ischemic attacks. The actuarial risk of death, stroke, or myocardial infarction over the first 5 years after a transient ischemic attack was approximately 8.4%/yr. The prognosis in this community-based cohort was better than that in previous reports. The high early risk of stroke means that investigation and treatment of new cases should commence as soon as possible.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebrovascular Disorders / epidemiology
  • Endarterectomy
  • Female
  • Follow-Up Studies
  • Humans
  • Ischemic Attack, Transient* / epidemiology
  • Ischemic Attack, Transient* / mortality
  • Ischemic Attack, Transient* / pathology
  • Ischemic Attack, Transient* / surgery
  • Male
  • Myocardial Infarction / epidemiology
  • Probability
  • Prognosis