The Library
One-year risk of stroke after transient ischemic attack or minor stroke in Hunter New England, Australia (INSIST study)
Tools
Tomari, Shinya, Levi, Christopher R., Hollilday, Elizabeth, Lasserson, Daniel , Valseras, Jose M., Dewey, Helen M., Barber, P. Alan, Spratt, Neil J., Cadihac, Dominique A., Feigin, Valery L., Rothwell, Peter M., Zareie, Hossein, Garcia-Esperon, Carlos, Davey, Andrew, Najib, Nashwa, Sales, Milton and Magin, Parker (2021) One-year risk of stroke after transient ischemic attack or minor stroke in Hunter New England, Australia (INSIST study). Frontiers in Neurology, 12 . 791193. doi:10.3389/fneur.2021.791193 ISSN 1664-2295.
|
PDF
WRAP-One-year-risk-stroke-ischemic-stroke-Hunter-New-England-Australia-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1761Kb) | Preview |
|
PDF
WRAP-One-year-risk-stroke-transient-ischemic-attack-Hunter-New-England-Australia-2021.pdf - Accepted Version Embargoed item. Restricted access to Repository staff only - Requires a PDF viewer. Download (315Kb) |
Official URL: https://doi.org/10.3389/fneur.2021.791193
Abstract
Background: One-year risk of stroke in transient ischemic attack and minor stroke (TIAMS) managed in secondary care settings has been reported as 5-8%. However, evidence for the outcomes of TIAMS in community care settings is limited.
Methods: The INternational comparison of Systems of care and patient outcomes In minor Stroke and TIA (INSIST) study was a prospective inception cohort community-based study of patients of 16 general practices in the Hunter–Manning region (New South Wales, Australia). Possible-TIAMS patients were recruited from 2012 to 2016 and followed-up for 12 months post-index event. Adjudication as TIAMS or TIAMS-mimics was by an expert panel. We established 7-day, 90-day, and one-year risk of stroke, TIA, myocardial infarction (MI), coronary or carotid revascularization procedure and death; and medications use at 24 hours post-event.
Results: Of 613 participants (mean age; 70 ± 12 years), 298 (49%) were adjudicated as TIAMS. TIAMS-group participants had ischemic strokes at 7-days, 90-days, and one-year, at Kaplan-Meier (KM) rates of 1% (95% confidence interval; 0.3, 3.1), 2.1% (0.9, 4.6), and 3.2% (1.7, 6.1), respectively, compared to 0.3%, 0.3% and 0.6% of TIAMS-mimic-group participants. At one year, TIAMS-group-participants had twenty-five TIA events (KM rate: 8.8%), two MI events (0.6%), four coronary revascularization (1.5%), eleven carotid revascularization (3.9%) and three death (1.1%), compared to 1.6%, 0.6%, 1.0%, 0.3% and 0.6% of TIAMS-mimic-group participants. Of 167 TIAMS-group participants who commenced or received enhanced therapies, 95 (57%) were treated within 24 hours post-index event. For TIAMS-group participants who commenced or received enhanced therapies, time from symptom onset to treatment was median 9.5 hours [IQR 1.8-89.9]).
Conclusion: One-year risk of stroke in TIAMS participants was lower than reported in previous studies. Early implementation of antiplatelet/anticoagulant therapies may have contributed to the low stroke recurrence.
Item Type: | Journal Article | ||||||
---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RC Internal medicine | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
Library of Congress Subject Headings (LCSH): | Transient ischemic attack, Cerebrovascular disease | ||||||
Journal or Publication Title: | Frontiers in Neurology | ||||||
Publisher: | Frontiers Research Foundation | ||||||
ISSN: | 1664-2295 | ||||||
Official Date: | 20 December 2021 | ||||||
Dates: |
|
||||||
Volume: | 12 | ||||||
Article Number: | 791193 | ||||||
DOI: | 10.3389/fneur.2021.791193 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||
Date of first compliant deposit: | 6 December 2021 | ||||||
Date of first compliant Open Access: | 20 December 2021 | ||||||
RIOXX Funder/Project Grant: |
|
||||||
Related URLs: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year