Stroke, Vol 21, 848-853, Copyright © 1990 by American Heart Association
M Dennis, J Bamford, P Sandercock and C Warlow
In a community-based study of approximately 105,000 people, 184 presented
with a transient ischemic attack during the 5 years between 1981 and 1986;
we believe these persons represent almost all new cases of transient
ischemic attack going to a doctor during that period. During a mean
follow-up of 3.7 years 49 patients died, 45 had a first- ever stroke, and
17 had a myocardial infarction. Cardiac disease accounted for 17 (35%)
deaths, while stroke was the cause of death in 15 patients (31%). The
average actuarial risk of death was approximately 6.3%/yr, slightly greater
than that expected for similar people without transient ischemic attacks
(risk ratio [observed divided by expected] = 1.4). The actuarial risk of
stroke was 11.6% during the first year after a transient ischemic attack
and approximately 5.9%/yr over the first 5 years. Patients who suffered a
transient ischemic attack had a 13-fold excess risk of stroke during the
first year and a sevenfold excess risk over the first 7 years compared with
people without transient ischemic attacks. The actuarial risk of death,
stroke, or myocardial infarction over the first 5 years after a transient
ischemic attack was approximately 8.4%/yr. The prognosis in this
community-based cohort was better than that in previous reports. The high
early risk of stroke means that investigation and treatment of new cases
should commence as soon as possible.
ARTICLES
Prognosis of transient ischemic attacks in the Oxfordshire Community Stroke Project
University Department of Clinical Neurology, Radcliffe Infirmary, Oxford, England.
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