Abstract 2876: Factors Associated with Transient Symptoms in Ischemic Stroke

Abstract

Background and Purpose: There may be no qualitative difference of the causes and risk factors between transient symptoms with infarction (TSI) on diffusion weighted images and ischemic stroke. However, it is uncertain for baseline characteristics which associate with transient symptoms in ischemic stroke. We compared the clinical profiles of patients with TSI with those with ischemic stroke. Methods: Consecutive patients presented within 24 hours of ischemic stroke onset with diffusion abnormalities between April 2008 and March 2011 were identified from a nationwide multicenter prospective stroke registry. Clinical profiles including risk factors, medication histories, laboratory findings, and stroke subtypes according to Trial of ORG 10172 in Acute Stroke Treatment criteria were compared between patients with TSI and those with ischemic stroke. Results: A total of 6,766 patients were identified, of whom 226 (3.3%) had TSI. In both univariate and multivariate analyses, younger age (62.1±12.0 vs. 67.8±12.7 [mean±SD]; β=-0.027, p<0.001), occurrence during activity (90.3 vs. 72%; β=1.123, p<0.001), more history of TIA (15 vs 2.4%; β=1.952, p<0.001), less history of stroke (14.6 vs. 22.2%; β=-0.483, p=0.007), less diabetes mellitus (20.4 vs. 30.6%, β=-0.503, p=0.001), and more cryptogenic stroke (21.7 vs. 8.2%; β=0.831, p<0.001) were associated with TSI. Prestroke use of statin or antiplatelet agents, prothrombin time, and platelet count were not associated with TSI. However, TSI patients were more likely to be on anti-coagulants (β=0.791, p=0.007) despite less likelihood of history of atrial fibrillation (β=-0.631, p=0.004) in multivariate analysis. Conclusions: TSI differs from ischemic stroke in various initial clinical aspects. Further study is needed to determine whether these different clinical features affect higher early risk of recurrence of stroke in TSI.