Long-Term Prognosis of Transient Ischemic Attacks and Reversible Ischemic Neurologic Deficits: A Hospital-Based Study

Abstract

A hospital-based series of 712 patients with either transient ischemic attacks (TIAs) or reversible ischemic neurologic deficits (RINDs) was followed prospectively for 4 years in order to determine the long-term prognosis for cerebral and cardiac events in this group. The annual recurrence rates for new TIAs were 15.9, 5.3, 4.7 and 3.5 % in the 1st, 2nd, 3rd and 4th year, respectively, and the corresponding ones for fatal and nonfatal strokes were 3.37, 2.36, 1.7 and 1.3%. Strokes tended to occur in the 1st follow-up year (51%). The ratio of cerebral to cardiac deaths was 2.4. The survival of patients with RIND was similar to that of patients with TIA. Both survival rates were lower than those of an age- and sex-matched cohort sampled from the general population. Male gender emerged as a reliable predictor for cardiac events (p < 0.01), multiple TIA or RIND on admission predicted subsequent TIA (p < 0.001) but not stroke. A history of hypertension predicted cerebral death (p < 0.01), and a history of cardiac disease predicted cerebral (p < 0.01) and cardiac death (p < 0.05). Overall mortality depended on an age > 60 years (p < 0.05), hypertension (p < 0.05) and cardiac disease (p < 0.001).