Published Online
on December 1, 2005

A more recent version of this article appeared on January 1, 2006

This Article Full Text (PDF) All Versions of this Article: 37/1/50    most recent 01.STR.0000195209.26543.8fv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Correia, M. Articles by Carolina Silva, M. Search for Related Content PubMed PubMed Citation Articles by Correia, M. Articles by Carolina Silva, M. Related Collections Transient Ischemic Attacks

Submitted on June 30, 2005
Revised on September 17, 2005
Accepted on October 13, 2005

Transient Ischemic Attacks in Rural and Urban Northern Portugal. Incidence and Short-Term Prognosis

Manuel Correia MD^*; Mário R. Silva MD; Rui Magalhães BSc; Laura Guimarães PhD; and M. Carolina Silva PhD

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.

^* To whom correspondence should be addressed. 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

This article has been cited by other articles:

				A. Chandratheva, Z. Mehta, O. C. Geraghty, L. Marquardt, P. M. Rothwell, and On behalf of the Oxford Vascular Study Population-based study of risk and predictors of stroke in the first few hours after a TIA Neurology, June 2, 2009; 72(22): 1941 - 1947. [Abstract] [Full Text] [PDF]

				J. H. Lichtman, S. B. Jones, E. Watanabe, N. B. Allen, Y. Wang, V. J. Howard, and L. B. Goldstein Elderly Women Have Lower Rates of Stroke, Cardiovascular Events, and Mortality After Hospitalization for Transient Ischemic Attack Stroke, June 1, 2009; 40(6): 2116 - 2122. [Abstract] [Full Text] [PDF]

				J. D. Easton, J. L. Saver, G. W. Albers, M. J. Alberts, S. Chaturvedi, E. Feldmann, T. S. Hatsukami, R. T. Higashida, S. C. Johnston, C. S. Kidwell, et al. Definition and Evaluation of Transient Ischemic Attack: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease: The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke, June 1, 2009; 40(6): 2276 - 2293. [Abstract] [Full Text] [PDF]

				C. M. Wu, K. McLaughlin, D. L. Lorenzetti, M. D. Hill, B. J. Manns, and W. A. Ghali Early Risk of Stroke After Transient Ischemic Attack: A Systematic Review and Meta-analysis Arch Intern Med, December 10, 2007; 167(22): 2417 - 2422. [Abstract] [Full Text] [PDF]

				B. L. Cucchiara, S. R. Messe, R. A. Taylor, J. Pacelli, D. Maus, Q. Shah, and S. E. Kasner Is the ABCD Score Useful for Risk Stratification of Patients With Acute Transient Ischemic Attack? Stroke, July 1, 2006; 37(7): 1710 - 1714. [Abstract] [Full Text] [PDF]