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(Stroke. 2006;37:50.)
© 2006 American Heart Association, Inc.

Original Contributions

Transient Ischemic Attacks in Rural and Urban Northern Portugal

Incidence and Short-Term Prognosis

From the Serviço de Neurologia (M.C.), Hospital Geral de Santo António, Porto, Portugal; Serviço de Neurologia (M.R.S.), Hospital de S. Pedro, Vila Real, Portugal; Departamento de Estudos de Populações (R.M.), Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; Laboratório de Ecotoxicologia (L.G.), Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR), Universidade do Porto, Portugal; and Departamento de Estudos de Populações (M.C.S.), Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal.

Correspondence to Manuel Correia, MD, Serviço de Neurologia, Hospital Geral de Santo António, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal. E-mail nedcv{at}mail.telepac.pt

Background and Purpose— There are no community-based studies on the incidence of transient ischemic attacks (TIAs) in Portugal. This study was designed to determine TIA incidence and the risk of stroke occurrence in rural and urban populations in northern Portugal.

Methods— All suspected first-ever TIAs occurring between October 1998 and September 2000 in 18 677 residents in a rural municipality and 86 023 living in the city of Porto were entered into a population-based registry. Standard definitions and comprehensive sources of information were used for identification of patients who were followed up at 3 and 12 months after the TIA.

Results— During a 24-month period, 141 patients with a first-ever TIA were registered, 36 in rural and 104 in urban areas. The vascular territory was carotid in 66.7% of the patients, vertebrobasilar in 29.1%, and undetermined in 4.3%. The overall crude annual incidence rate per 1000 was 0.67 (95% CI, 0.45 to 1.04), 0.61 (95% CI, 0.38 to 1.01) for rural, and 0.96 (95% CI, 0.43 to 2.33) for urban populations. The risk of stroke within the first 7 days of the index event was 12.8% (95% CI, 7.3 to 18.3), reaching 21.4% (95% CI, 14.6 to 28.1) at 1 year. Three factors were associated with stroke occurrence within 120 days after TIA: patients’ age 65 years and an episode in the carotid distribution lasting 3 hours.

Conclusions— The incidence of TIA in northern Portugal, particularly in rural populations, ranks among the highest reported in community-based studies, following closely the stroke incidence trend (ACINrpc). Early recognition of TIA by patients and physicians is crucial for effective stroke prevention.

Key Words: epidemiology • incidence • prognosis • transient ischemic attack

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