Predictors of major vascular events in patients with a transient ischemic attack or nondisabling stroke. The Dutch TIA Trial Study Group.

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Abstract

Very few studies have addressed the identification of prognostic factors in patients with a transient ischemic attack or minor stroke. We prospectively studied the prognostic value of clinical, laboratory, radiological, and electrocardiographic findings in 997 patients with a transient ischemic attack and 2,130 patients with a minor stroke who were entered into a multicenter clinical trial. The mean follow-up period was 2.6 years. A total of 302 patients died (212 from a vascular cause), 272 had a stroke, and 200 had a cardiac event. By means of a multivariate analysis we identified the following independent risk factors for stroke, myocardial infarction, or vascular death: age of > 65 years; male sex; dysarthria; multiple attacks; diabetes; angina pectoris; intermittent claudication; computed tomographic evidence of any cerebral infarct, especially a border zone infarct or white matter hypodensity; and electrocardiographic evidence of an anteroseptal infarct, ST depression, left ventricular hypertrophy, or left atrial conduction delay. Protective predictors were monocular attacks only or the presence of rotatory dizziness. A limited number of easily obtainable characteristics are powerful predictors of major vascular events in patients with cerebral ischemia.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

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