English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

According to studies between 1997 and 2003, the risk of stroke or acute coronary syndrome after a “transient ischemic attack” (TIA) or minor stroke ranges between 12-20% (1,2). Currently, patients are triaged depending on stroke risk, which is calculated using age, blood pressure, clinical symptoms, duration of symptoms, and presence of diabetes (ABCD2). If ABCD2 is equal to or higher then 4, emergency care is recommended for 24 hours starting from the beginning of the symptoms (3). Although important developments took place in the management of TIA after 2003, the prognosis of the disease and role of risk scoring systems in emergency care has not yet been clearly established. Therefore, the TIAregistry.org project was developed to define the current profile and etiologic factors, to determine short(1 year) and long-term (5 years) outcomes, and to re-evaluate risk. The “One-year risk of stroke after TIA or minor stroke” trial by Amarenco et al. (4) reported some of the data obtained by the TIAregistry.org project. This project was conducted in 61 centers in 21 countries and included patients who had TIA or minor stroke within 7 days of being examined by a stroke specialist. Between June 2009 and December 2011, 4789 patients were registered for the study. Of these, 4583 were included in the analyses and 3593 (78.4%) were evaluated by a stroke specialist during the first 24 hours after the event. The mean age of the patients was 66.1±13.2 years and the median duration of hospital stay was 4 days. The mean ABCD2 score for patients who were evaluated during the first 24 hours was 4.7±1.5, and for patients who were evaluated after the first 24 hours it was 3.8±1.6 (p<0.001). This study found acute cerebral infarction in 33.4% of patients, at least one extracranial or intracranial stenosis in 50%, and atrial fibrillation in 10.4% of patients. A Kaplan-Meier estimate for 1-year composite cardiovascular outcomes was 6.2% (95% confidence interval 5.5-7.0). Kaplan-Meier estimates for stroke rates on the 2nd, 7th, 30th, 90th, and 365th days were 1.5%, 2.1%, 2.8%, 3.7%, and 5.1%, respectively. Multivariable analyses revealed that each of multiple infarctions, large artery atherosclerosis, or ABCD2 score 6-7 increased stroke risk more than twice. Although the event rate was much lower than in historical cohorts, the ABCD2 score was still effective for risk determination in patients who were treated urgently and intensively. In addition, 22% of recurrent strokes were seen in patients with ABCD2 scores lower than 4 who had accompanying modifiable risk factors such as atrial fibrillation or 50% or more ipsilateral internal carotid artery stenosis.

One-year Risk of Stroke after Transient Ischemic Attack or Minor Stroke