Abstract
BackgroundTransient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA.Methods176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded.Results22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial ≥ 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001).ConclusionTIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events.
Highlights
Transient ischemic attack (TIA) patients are at high vascular risk
Patients had to undergo cerebral magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) sequences within 5 days after onset of symptoms, which was the case in 225 patients. 49 patients were excluded for the following reasons: competing differential diagnosis as assessed by the attending neurologist, 41 cases; malignancy requiring active treatment, 7 cases; concomitant participation in a pharmaceutical trial; 1 case
The present study demonstrates that TIA patients with ultrasonographic evidence of extracranial or intracranial stenoocclusive disease are at high risk of further cerebral ischemic events during medium- to long-term follow-up
Summary
Transient ischemic attack (TIA) patients are at high vascular risk. After a transient ischemic attack (TIA), patients are at high risk to develop further vascular events. The early risk of stroke after TIA is comparable to, or even higher than, the short-term risk of myocardial infarction (MI) and major cardiovascular complications in patients presenting with chest pain [7]. Several clinical characteristics such as advanced age [2,8,9,10], diabetes (page number not for citation purposes). The predictive power of the ABCD2 model seems to be partially explained by identification of those patients likely to have experienced a true TIA [18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
