JAMA | 66 years of data show: TIA is small, stroke risk is not small!

Transient cerebral isoemia attack (TIA) is a transient blood supply shortage in the cervical artery or vertebral-substrate artery system, which causes sudden, transient, reversible neurological dysfunction caused by isothermic cerebral isemia.
TIA seizures last for several minutes and usually recover completely within 30 minutes.
TIA onset generally has no precursor, there is a sexual nervous system positioning signs, but there is no evidence of responsible lesions.
TIA is commonly known as a "small stroke" because patients tend to recover fully within 24 hours, with no sequelae.
, however, previous studies have found that TIA patients have a high risk of early stroke, with a 4% to 10% incidence of cerebral infarction within 7 days of onset.
The incidence of cerebral infarction increased not only (10%-20%) within 90 days of the onset of TIA, but also the risk of myocardial infarction and sudden death, so 90 days is now consistently regarded as a "high risk period" for cerebral infarction.
in recent decades, the short- and long-term risk of stroke after TIA has improved as medical care has improved, but the risk of occurrence has not been specifically studied.
, experts and scholars from Harvard Medical School and the University of Texas Health Research Center conducted a comprehensive retrospective analysis of post-TIA stroke risk.
results were published in the latest issue of the Journal of the American Medical Association (JAMA).
retrospective analysis, known as the Framingham Heart Study, dates back to 1948 and follows and reviews data from 14,059 people from 1948 to 2017.
follow-up period, a total of 435 people had TIA, with a rate of 1.19 per 1000 years.
, the researchers matched TIA patients with non-TIA participants by a ratio of 1:5 to assess stroke risk at different points in time (7 days, 30 days, 90 days, and up to 10 years).
results showed that TIA patients had a 4.5-5 times stroke rate compared to non-TIA participants after adjusting for other vascular risk factors, such as high blood pressure, high cholesterol, or diabetes.
, 29.5 percent (130/435) of TIA patients had stroke during an average follow-up time of 8.9 years after TIA.
of the 130 strokes, 28 (22%) occurred within 7 days, while the other 40 (30.8%), 51 (39%) and 63 (48.5%) occurred 30 days, 90 days and more than 1 year after TIA, respectively.
, the mid-life of stroke was 1.6 years.
, the researchers also compared stroke rates over three time periods: before 1985, 1986-1999, and 2000-2017.
found that in these three eras, the rate of stroke in the 90 days after TIA fell from 16.7% to 11.1% and 5.9%, respectively, with a risk of 0.60 (95% CI, 0.33-1.12) and 0.32 (95% CI, 0.14-0.75).
, TIA patients have had lower rates of smoking in recent years (24% vs. 14%) than patients in previous periods, but higher rates of diabetes and atrial fibrillation.
, professor Vasileios-Arsenios Lioutas, a neuroscientist at Harvard Medical School and author of the paper, said: "Our results suggest that the risk of stroke after TIA lasts for a long time.
, follow-up to TIA patients should be extended beyond 90 days, while closely monitoring the control of their cardiovascular risk factors.
", stroke is no small matter, the risk of stroke after TIA significantly increased, the stroke monitoring time for such patients should be extended to 90 days.
: Lioutas VA, et al. Incidence of Transient Ischemic Attack and Association With Long-term Risk of Stroke. JAMA. 2021 Jan 26; 325(4):373-381. Doi:10.1001/jama.2020.25071.MedSci Original Source: MedSci Original Copyright Notice: All notes on this website "Source: Met Medical" or "Source: MedSci Original" text, images and audio-visual materials, copyrights are owned by Metz Medicine, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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