David Tong, MD
In patients who have had a transient ischemic attack (TIA), what is the early risk for stroke at 2, 30, and 90 days?
Cohort studies reporting the outcome of early risk for stroke at 2, 30, or 90 days in patients with TIA were selected. Randomized controlled trials and case series were excluded.
MEDLINE (1966 to present), EMBASE/Excerpta Medica (1980 to present), Cochrane Database of Systematic Reviews (1996 to present), CINAHL (1982 to present), BIOSIS previews (1980 to present), conference proceedings, and reference lists were searched and experts were contacted. 11 cohort studies (n = 7238, 53% women, mean age range 56 to 75 y) met the selection criteria.
The incidence of stroke ranged from 1.4% to 9.9% at 2 days, 3.2% to 18% at 30 days, and 4.0% to 17% at 90 days. Meta-analysis showed increasing early risk for stroke at 2, 30, and 90 days after TIA (Table). When only studies with active outcome ascertainment were pooled, risk for stroke was higher than that in all studies (Table).
Risk for stroke is high at 2, 30, and 90 days after transient ischemic attack.
Early risk for stroke in patients who have had a transient ischemic attack*
*CI defined in Glossary. Analysis based on a random-effects model.
Tong D. Review: Risk for stroke is high at 2, 30, and 90 days after transient ischemic attack. Ann Intern Med. ;148:JC4–12. doi: 10.7326/0003-4819-148-12-200806170-02012
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Published: Ann Intern Med. 2008;148(12):JC4-12.
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