Background
The risk of future stroke after transient ischemic attack (TIA) has been widely studied,
but most findings were obtained for classically defined TIA (time-defined TIA). A
new definition of TIA, that is, tissue-defined TIA, which requires the absence of
fresh brain infarction on magnetic resonance imaging, could change stroke risk assessments.
We, therefore, aimed to evaluate the risk of future stroke in patients with tissue-defined
TIA.
Methods
We retrospectively reviewed 74 patients with tissue-defined TIA, who could be followed
for 2 years. Clinical, laboratory, and radiological data were collected and compared
between groups that did and did not develop ischemic stroke within the 2-year period.
Results
Ischemic stroke occurred in 11 patients (14.9%). Increased age, hemiparesis, and/or
dysarthria during the TIA, old cerebral infarction revealed by magnetic resonance
imaging, and large-artery stenosis detected by magnetic resonance angiography and/or
ultrasonography tended to increase the risk of future stroke, but no individual factor
showed statistically significant effect. TIA etiology did not significantly affect
the risk. ABCD2 score, an established score for predicting stroke after time-defined
TIA, showed only a weak association with future stroke. In contrast, new scores that
we created reliably predicted future stroke; these included the APO (age, paresis,
and old cerebral infarction) and APOL (age, paresis, old cerebral infarction, and
large-artery stenosis) scores. The areas under the receiver operating characteristic
curves were .662, .737, and .807 for ABCD2, APO, and APOL, respectively.
Conclusions
Compared with the established measures, our newly created scores could predict future
stroke for tissue-defined TIA more reliably.
Key Words
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Article info
Publication history
Published online: January 06, 2014
Accepted:
November 20,
2013
Received in revised form:
September 9,
2013
Received:
June 11,
2013
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.020
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
