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https://www.readbyqxmd.com/read/29920644/non-cardioembolic-tia-and-ischemic-stroke-implications-of-severity
#1
S Åsberg, B Farahmand, P Hasvold, S Johansson, P Appelros
OBJECTIVES: Our purpose was to explore major vascular and bleeding outcomes in relation to risk and severity scores (ABCD2 or NIHSS) in patients with transient ischemic attack (TIA) or acute ischemic stroke (AIS). METHODS: This nationwide observational study was based on data from 4 national registries. Outcomes were assessed by Kaplan-Meier and Cox regression analyses. RESULTS: The total cohort comprised 21 268 patients (median age 73 years, 47...
June 19, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29915123/efficacy-and-safety-of-ticagrelor-in-relation-to-aspirin-use-within-the-week-before-randomization-in-the-socrates-trial
#2
K S Lawrence Wong, Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Anders Himmelmann, Scott E Kasner, Mikael Knutsson, Per Ladenvall, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, S Claiborne Johnston
BACKGROUND AND PURPOSE: SOCRATES (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes), comparing ticagrelor with aspirin in patients with acute cerebral ischemia, found a nonsignificant 11% relative risk reduction for stroke, myocardial infarction, or death ( P =0.07). Aspirin intake before randomization could enhance the effect of ticagrelor by conferring dual antiplatelet effect during a high-risk period for subsequent stroke. Therefore, we explored the efficacy and safety of ticagrelor versus aspirin in the patients who received any aspirin the week before randomization...
June 18, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29766771/five-year-risk-of-stroke-after-tia-or-minor-ischemic-stroke
#3
Pierre Amarenco, Philippa C Lavallée, Linsay Monteiro Tavares, Julien Labreuche, Gregory W Albers, Halim Abboud, Sabrina Anticoli, Heinrich Audebert, Natan M Bornstein, Louis R Caplan, Manuel Correia, Geoffrey A Donnan, José M Ferro, Fernando Gongora-Rivera, Wolfgang Heide, Michael G Hennerici, Peter J Kelly, Michal Král, Hsiu-Fen Lin, Carlos Molina, Jong Moo Park, Francisco Purroy, Peter M Rothwell, Tomas Segura, David Školoudík, P Gabriel Steg, Pierre-Jean Touboul, Shinichiro Uchiyama, Éric Vicaut, Yongjun Wang, Lawrence K S Wong
Background After a transient ischemic attack (TIA) or minor stroke, the long-term risk of stroke and other vascular events is not well known. In this follow-up to a report on 1-year outcomes from a registry of TIA clinics in 21 countries that enrolled 4789 patients with a TIA or minor ischemic stroke from 2009 through 2011, we examined the 5-year risk of stroke and vascular events. Methods We evaluated patients who had had a TIA or minor stroke within 7 days before enrollment in the registry. Among 61 sites that participated in the 1-year outcome study, we selected 42 sites that had follow-up data on more than 50% of their enrolled patients at 5 years...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29525079/comparison-of-clinical-characteristics-among-subtypes-of-visual-symptoms-in-patients-with-transient-ischemic-attack-analysis-of-the-prospective-multicenter-registry-to-identify-subsequent-cardiovascular-events-after-tia-promise-tia-registry
#4
Koji Tanaka, Toshiyuki Uehara, Kazumi Kimura, Yasushi Okada, Yasuhiro Hasegawa, Norio Tanahashi, Akifumi Suzuki, Jyoji Nakagawara, Kazumasa Arii, Shinji Nagahiro, Kuniaki Ogasawara, Shinichiro Uchiyama, Masayasu Matsumoto, Koji Iihara, Kazunori Toyoda, Kazuo Minematsu
BACKGROUND: A transient visual symptom (TVS) is a clinical manifestation of transient ischemic attack (TIA). The aim of this study was to investigate differences in clinical characteristics among subtypes of TVS using multicenter TIA registry data. MATERIALS AND METHODS: Patients with TIA visiting within 7 days of onset were prospectively enrolled from 57 hospitals between June 2011 and December 2013. Clinical characteristics were compared between patients with 3 major subtypes of TVS (transient monocular blindness [TMB], homonymous lateral hemianopia [HLH], and diplopia)...
June 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29482544/reducing-time-to-unit-among-patients-referred-to-an-outpatient-stroke-assessment-unit-with-a-novel-triage-process-a-prospective-cohort-study
#5
Maximilian B Bibok, Kristine Votova, Robert F Balshaw, Mary L Lesperance, Nicole S Croteau, Anurag Trivedi, Jaclyn Morrison, Colin Sedgwick, Andrew M Penn
BACKGROUND: To evaluate the performance of a novel triage system for Transient Ischemic Attack (TIA) units built upon an existent clinical prediction rule (CPR) to reduce time to unit arrival, relative to the time of symptom onset, for true TIA and minor stroke patients. Differentiating between true and false TIA/minor stroke cases (mimics) is necessary for effective triage as medical intervention for true TIA/minor stroke is time-sensitive and TIA unit spots are a finite resource. METHODS: Prospective cohort study design utilizing patient referral data and TIA unit arrival times from a regional fast-track TIA unit on Vancouver Island, Canada, accepting referrals from emergency departments (ED) and general practice (GP)...
February 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29251055/validation-of-a-multivariate-clinical-prediction-model-for-the-diagnosis-of-mild-stroke-transient-ischemic-attack-in-physician-first-contact-patient-settings
#6
Maximilian B Bibok, Andrew M Penn, Mary L Lesperance, Kristine Votova, Robert Balshaw
We validate our previously developed (DOI: 10.1101/089227) clinical prediction rule for diagnosing transient ischemic attack on the basis of presenting clinical symptoms and compare its performance with the ABCD2 score in first-contact patient settings. Two independent and prospectively collected patient validation cohorts were used: (a) referral cohort-prospectively referred emergency department and general practitioner patients ( N = 877); and (b) SpecTRA cohort-participants recruited as part of the SpecTRA biomarker project ( N = 545)...
December 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29212745/factors-associated-with-focal-computed-tomographic-perfusion-abnormalities-in-supratentorial-transient-ischemic-attacks
#7
Ivo A Meyer, Carlo W Cereda, Pamela N Correia, Jean-Baptiste Zerlauth, Francesco Puccinelli, David C Rotzinger, Michael Amiguet, Philippe Maeder, Reto A Meuli, Patrik Michel
BACKGROUND AND PURPOSE: Computed tomographic perfusion (CTP) is useful in diagnosis of patients with transient focal neurological symptoms. In acute imaging of patients with a suspected transient ischemic attack (TIA), it remains unclear which patients develop focal perfusion abnormalities (FPA), that is, hypoperfusion or hyperperfusion. We aimed at determining independent factors associated with FPA in patients with supratentorial TIAs. METHODS: We prospectively collected consecutive patients with supratentorial TIAs defined by the traditional time-based definition who underwent CTP within 24 hours of symptom onset...
January 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29175888/when-has-service-provision-for-transient-ischaemic-attack-improved-enough-a-discrete-event-simulation-economic-modelling-study
#8
Pelham Barton, James P Sheppard, Cristina M Penaloza-Ramos, Sue Jowett, Gary A Ford, Daniel Lasserson, Jonathan Mant, Ruth M Mellor, Tom Quinn, Peter M Rothwell, David Sandler, Don Sims, Richard J McManus
OBJECTIVES: The aim of this study was to examine the impact of transient ischaemic attack (TIA) service modification in two hospitals on costs and clinical outcomes. DESIGN: Discrete event simulation model using data from routine electronic health records from 2011. PARTICIPANTS: Patients with suspected TIA were followed from symptom onset to presentation, referral to specialist clinics, treatment and subsequent stroke. INTERVENTIONS: Included existing versus previous (less same day clinics) and hypothetical service reconfiguration (7-day service with less availability of clinics per day)...
November 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/29145195/contemporary-epidemiology-of-transient-ischemic-attack-in-dijon-france-2013-2015
#9
Yannick Béjot, Céline Brenière, Mathilde Graber, Lucie Garnier, Jérôme Durier, Christelle Blanc-Labarre, Benoit Delpont, Maurice Giroud
BACKGROUND: We aimed to evaluate the epidemiological features of transient ischemic attack (TIA). METHODS: All TIAs were prospectively collected in Dijon, France, using a population-based registry (2013-2015). TIAs were considered the first-ever in patients who had no previous cerebrovascular events (CVEs); otherwise they were considered recurrent TIAs. Annual incidence (first-ever TIAs) and attack rates (first-ever and recurrent TIAs) were calculated. RESULTS: Four hundred twenty TIAs were registered (255 first-ever and 165 recurrent TIAs, mean age: 74...
2017: Neuroepidemiology
https://www.readbyqxmd.com/read/29108805/stroke-risk-is-low-after-urgently-treated-transient-ischemic-attack
#10
Thea Vigen, Bente Thommessen, Ole Morten Rønning
BACKGROUND: Over the last decades, the approach to patients with transient ischemic attack (TIA) has shifted from treating only patients considered at high risk of recurrent stroke, to referring all patients with TIA to urgent assessment and immediate initiation of preventive treatment. The data on how this change has influenced the stroke rate after TIA are limited. Thus, the primary aim of this study was to identify the incidence of stroke recurrence after TIA. Second, we wanted to evaluate the ABCD2 score as a predictor of recurrent stroke...
February 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29053901/familial-hypercholesterolaemia-in-patients-with-ischemic-stroke-or-transient-ischemic-attack
#11
Thomas Toell, Lukas Mayer, Raimund Pechlaner, Stefan Krebs, Karin Willeit, Clemens Lang, Christian Boehme, Barbara Prantl, Michael Knoflach, Julia Ferrari, Philipp Fuchs, Wolfgang Prokop, Andrea Griesmacher, Wilfried Lang, Stefan Kiechl, Johann Willeit
BACKGROUND AND AIMS: Identification of patients with familial hypercholesterolemia (FH) is a prerequisite for the appropriate management of their excess cardiovascular risk. It is currently unknown how many patients with acute ischemic stroke or transient ischemic attack (TIA) are affected by FH and whether systematic screening for FH is warranted in these patients. METHODS: The prevalence of a clinical diagnosis of FH was estimated in a large representative series of patients with acute ischemic stroke or TIA (ABCD2 score ≥3) using the Dutch Lipid Clinic Network Algorithm (DLCNA; possible FH ≥3, probable/definite FH ≥6)...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28814097/prominent-deep-medullary-veins-a-predictive-biomarker-for-stroke-risk-from-transient-ischemic-attack
#12
Yang Duan, Zhihua Xu, Hongyi Li, Xiaonan Cai, Cancan Chang, Benqiang Yang
Background Deep medullary veins (DMVs) are a biomarker of severity and prognosis in patients with acute cerebral infarction. However, their clinical significance remains unclear in patients with transient ischemic attack (TIA). Purpose To determine whether prominent deep medullary veins (PDMVs) are a predictive biomarker for stroke risk after TIA. Material and Methods Clinical and imaging data of 49 patients with TIA and 49 sex- and age-matched controls were studied. PDMVs were defined as DMVs with a score of 3 (TDMVs) or asymmetric DMVs (ADMVs), and the relationship between PDMVs and clinical features was analyzed...
May 2018: Acta Radiologica
https://www.readbyqxmd.com/read/28647418/comparison-of-stroke-prediction-accuracy-of-abcd2-and-abcd3-i-in-patients-with-transient-ischemic-attack-a-meta-analysis
#13
Meng Zhao, Shuo Wang, Dong Zhang, Yan Zhang, Xiaofeng Deng, Jizong Zhao
BACKGROUND: A direct comparison of the stroke prediction utility of the ABCD2 and ABCD3-I scores has not been performed. Thus, we conducted a diagnostic meta-analysis and applied the results to a hypothetical cohort of 1000 patients with transient ischemic attack (TIA) to assess the power of stroke prediction by ABCD2 and ABCD3-I scores. METHODS: Medline, PubMed, Embase, and manuscript references were searched to identify studies that directly compared the stroke predictive powers of ABCD2 and ABCD3-I scores...
October 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28603135/report-impact-of-drug-combination-of-clopidogrel-and-pantoprazole-in-the-prognosis-of-patients-with-transient-ischemic-attack
#14
RANDOMIZED CONTROLLED TRIAL
Min Lu
The study aimed to investigate the impact of clopidogrel combined with proton pump inhibitors (PPI) pantoprazole treatment on the prognosis of patients with transient ischemic attack (TIA). A total of 478 cases of TIA patients treated with clopidogrel were randomly assigned half to clopidogrel combined with pantoprazole treatment and the control groups (clopidogrel treatment alone) from January 2012 to January 20l4. The platelet aggregation before and after treatment and cerebrovascular events incidence within 90 days were compared and analyzed...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28592454/coated-platelets-predict-stroke-at-30-days-following-tia
#15
Angelia C Kirkpatrick, Andrea S Vincent, George L Dale, Calin I Prodan
OBJECTIVE: To examine the potential for coated-platelets, a subset of highly procoagulant platelets observed on dual agonist stimulation with collagen and thrombin, for predicting stroke at 30 days in patients with TIA. METHODS: Consecutive patients with TIA were enrolled and followed up prospectively. ABCD2 scores were obtained for each patient. Coated-platelet levels, reported as percent of cells converted to coated-platelets, were determined at baseline. The primary endpoint was the occurrence of stroke at 30 days...
July 11, 2017: Neurology
https://www.readbyqxmd.com/read/28506591/early-echocardiography-has-a-low-yield-in-patients-with-transient-ischemic-attack
#16
Elie Harmouche, Ghada A Mahmoud, Michael Ross, Jason Hockenberry, Robin Dharia, Fadi Nahab
STUDY OBJECTIVE: Current guidelines recommend patients presenting with transient ischemic attack (TIA) undergo echocardiography to evaluate for a cardiac source. However, echocardiography is not available daily at many centers. We assessed the yield from early transthoracic echocardiography (TTE) in consecutive patients with TIA evaluated in an emergency department observation unit (EDOU) protocol. METHODS: This observational cohort study took place in an academic medical center from January 1, 2011 to July 31, 2013...
August 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28500226/mr-perfusion-lesions-after-tia-or-minor-stroke-are-associated-with-new-infarction-at-7-days
#17
Jun Lee, Manabu Inoue, Michael Mlynash, Sharanpal K Mann, Carlo W Cereda, Michael Ke, Gregory W Albers, Jean M Olivot
OBJECTIVE: To investigate the relationship between acute perfusion-weighted imaging (PWI) lesions occurring within the first hours after a TIA or a minor brain infarction (BI) and the incidence of new BI detected on a systematic MRI at 1 week. METHODS: Consecutive patients who experienced a TIA or BI with a neurologic deficit that lasted <24 hours, did not receive any revascularization therapy (thrombolysis/thrombectomy), and underwent DWI/PWI at baseline and fluid-attenuated inversion recovery (FLAIR)/DWI 1 week after symptom onset were enrolled...
June 13, 2017: Neurology
https://www.readbyqxmd.com/read/28256416/the-triage-score-for-vertigo-or-dizziness-a-diagnostic-model-for-stroke-in-the-emergency-department
#18
COMPARATIVE STUDY
R Kuroda, T Nakada, T Ojima, M Serizawa, N Imai, N Yagi, A Tasaki, M Aoki, T Oiwa, T Ogane, K Mochizuki, M Kobari, H Miyajima
BACKGROUND: Vertigo or dizziness is a common occurrence, but it remains a challenging symptom when encountered in the emergency department (ED). A diagnostic score for stroke with high accuracy is therefore required. METHODS: A single-center observational study (498 patients) was conducted. The predictor variables were derived from a multivariate logistic regression analysis with Akaike information criterion. The outcome was the occurrence of stroke. We evaluated the utility of a new diagnostic score (TriAGe+) and compared it with the ABCD2 score...
May 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27904159/copeptin-as-a-biomarker-for-prediction-of-prognosis-of-acute-ischemic-stroke-and-transient-ischemic-attack-a-meta-analysis
#19
REVIEW
Qian Xu, Yunfan Tian, Hao Peng, Hongmei Li
This meta-analysis aimed to investigate the predictive effect of copeptin as a biomarker for the prognosis of acute ischemic stroke and transient ischemic attack. Electronic databases including PubMed, Medline, EMBASE, Web of Science and Cochrane Central were searched for studies assessing the association of copeptin level on admission with prognosis of acute ischemic stroke and transient ischemic attack. The Newcastle-Ottawa Quality assessment scale for cohort study was used to evaluate quality. A total of 1976 acute ischemic stroke patients from 6 studies were included, and 59% of patients were male...
May 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27751555/validation-and-comparison-of-imaging-based-scores-for-prediction-of-early-stroke-risk-after-transient-ischaemic-attack-a-pooled-analysis-of-individual-patient-data-from-cohort-studies
#20
COMPARATIVE STUDY
Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
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