Change search
ReferencesLink to record
Permanent link

Direct link
Long-Term Risk of Stroke after Transient Ischemic Attack
Department of Neurology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Riksstroke, Medicincentrum, University Hospital of Norrland, Umeå, Sweden.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-6681-0546
2017 (English)In: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 43, no 1-2, 25-30 p.Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: In the absence of active management, the stroke risk after a transient ischemic attack (TIA) may be high. Almost 10 years ago, the results of the EXPRESS and SOS-TIA studies called for a more rapid management of TIA patients. The purpose of this study was to investigate the other stroke risks in the longer term, after the implementation of a more active approach to TIA. We also wanted to assess the predictive value of the ABCD2 score in this context.

Methods: Riksstroke is the national stroke registry in Sweden. Data from Riksstroke's TIA module, and the national cause-of-death register, for the years 2011 and 2012 were used in this study. Stroke occurrence was monitored via Riksstroke. Cox's regression was used for risk evaluation. The predictive value of the ABCD2 score was assessed by calculating the area under the receiver operating characteristics curve.

Results: A total of 15,068 TIA episodes occurred in 14,102 patients. The follow-up time varied between 0 and 819 days, with an average of 417 days. The mortality for all TIA patients during the follow-up time was 7.1%. Of the unique patients, 545 had one or more strokes (3.9%), corresponding to 34 events per 1,000 person years. Significant risk factors for stroke were: age, previous TIA, atrial fibrillation (AF), oral anticoagulant (OAC) treatment, hypertension treatment, and the ABCD2 items speech impairment, unilateral weakness, and diabetes mellitus. The ABCD2 score correlated with a subsequent stroke, but its predictive value was low.

Conclusion: The risk of stroke is low after the acute phase of a TIA, probably lower than in previous studies. This may be due to better secondary prevention in recent years. Several risk factors predict stroke, notably hypertensive treatment, which may be inadequate; and AF, where OACs may be under-used. It is difficult to identify the role of the ABCD2 score in clinical practice.

Place, publisher, year, edition, pages
Basel, Switzerland: S. Karger, 2017. Vol. 43, no 1-2, 25-30 p.
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:oru:diva-53250DOI: 10.1159/000451061PubMedID: 27750222OAI: oai:DiVA.org:oru-53250DiVA: diva2:1039777
Available from: 2016-10-25 Created: 2016-10-24 Last updated: 2016-10-25Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Ström, Jakob O.
By organisation
School of Medical Sciences
In the same journal
Cerebrovascular Diseases
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 50 hits
ReferencesLink to record
Permanent link

Direct link