Transient Ischemic Attacks linked to long term Risk of Ischemic Strokes

A new study published in Circulation AHA delves into the long-term risks associated with transient ischemic attack (TIA). TIA is a condition characterised by temporary disruption of blood flow to the brain often considered a precursor to a full-blown stroke. While short-term risks post-TIA are known to be high, understanding the long-term implications is crucial for guiding preventive strategies.

The study included patients with a first-time TIA registered in the Danish Stroke Registry between January 2014 and December 2020. Researchers led by Vinding N. E.matched these patients with individuals from the general population and with those who had experienced a first-time ischemic stroke based on age, sex, and calendar year.

• The 5-year incidence of ischemic stroke following TIA was 6.1%.
  
• This rate was significantly higher than the background population, which had an incidence of 1.5%.
• It was notably lower than the control group of patients who had experienced a first-time ischemic stroke, with an incidence of 8.9%.
• After adjusting for comorbidities, patients with TIA had an approximately five-fold higher risk of ischemic stroke compared to the background population.
• The 5-year mortality rate for patients with TIA was 18.6%, which was higher than the background population's rate of 14.8%.
• It was substantially lower than the mortality rate among patients who had experienced a first-time ischemic stroke, which stood at 30.1%.

This study underscores the significant long-term risks associated with TIA. Patients who experience a TIA face a considerably higher risk of developing ischemic stroke over a 5-year period compared to the general population. While the risk is elevated, it is lower than that of individuals who have already suffered a first-time ischemic stroke. These findings emphasise the importance of ongoing monitoring and preventive measures to reduce the risk of stroke in TIA patients, thereby potentially preventing more severe outcomes.

Reference:

Vinding, N. E., Butt, J. H., Lauridsen, M. D., Kristensen, S. L., Johnsen, S. P., Krøll, J., Graversen, P. L., Kruuse, C., Torp-Pedersen, C., Køber, L., & Fosbøl, E. L. Long-term incidence of ischemic stroke after transient ischemic attack: A nationwide study from 2014 to 2020. Circulation,2023;148(13):1000–1010. https://doi.org/10.1161/circulationaha.123.065446