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01-08-2014 | Original Communication

How predictors and patterns of stroke recurrence after a TIA differ during the first year of follow-up

Authors: F. Purroy, P. E. Jiménez Caballero, A. Gorospe, M. J. Torres, J. Álvarez-Sabin, P. Martínez-Sánchez, D. Cánovas, M. Freijo, J. A. Egido, J. M. Ramírez-Moreno, A. Alonso-Arias, A. Rodríguez-Campello, I. Casado-Naranjo, J. Martí-Fàbregas, Y. Silva, P. Cardona, A. Morales, A. García-Pastor, J. F. Arenillas, T. Segura, C. Jiménez, J. Masjuán

Published in: Journal of Neurology | Issue 8/2014

Abstract

The highest risk of subsequent stroke after a TIA occurs within the first week after the index event. However, the risk of stroke recurrence (SR) remains high during the first year of follow-up. We studied the temporal pattern and predictors of SR (at 7 days and from 7 days to 1-year follow-up). Between April 2008 and December 2009, we included 1,255 consecutive TIA patients from 30 Spanish stroke centers (PROMAPA study). We determined the short-term (at 7 days) and long-term (from 8 days to 1 year) risk of SR. Patients who underwent short-term recurrence and long-term recurrence were compared with regard to clinical findings, vascular territories, and etiology. Enough information (clinical variables and extracranial vascular imaging) was assessed in 1,137 (90.6 %) patients. The 7-day stroke risk was 2.6 %. 32 (3.0 %) patients had an SR after 7-day follow-up. Multiple TIA (HR 3.50, 1.67–7.35, p = 0.001) and large artery atherosclerosis (HR 2.51, 1.17–5.37, p = 0.018) were independent predictors of early SR, whereas previous stroke (HR 1.40, 1.03–1.92, p = 0.034) and coronary heart disease (2.65, 1.28–5.50, p = 0.009) were independent predictors of late SR. Notoriously, 80 % of SR happened in the same territory of the index TIA at 7-day follow-up, whereas only 38 % during the long-term follow-up (p < 0.001). Different predictors of SR were identified throughout the follow-up period. Moreover, the ischemic mechanism differed in early and late stroke recurrences.

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Title: How predictors and patterns of stroke recurrence after a TIA differ during the first year of follow-up
Authors: F. Purroy
P. E. Jiménez Caballero
A. Gorospe
M. J. Torres
J. Álvarez-Sabin
P. Martínez-Sánchez
D. Cánovas
M. Freijo
J. A. Egido
J. M. Ramírez-Moreno
A. Alonso-Arias
A. Rodríguez-Campello
I. Casado-Naranjo
J. Martí-Fàbregas
Y. Silva
P. Cardona
A. Morales
A. García-Pastor
J. F. Arenillas
T. Segura
C. Jiménez
J. Masjuán
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 8/2014
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-014-7390-z

At a glance: The STEP trials

Springer Medicine

How predictors and patterns of stroke recurrence after a TIA differ during the first year of follow-up

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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