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Open Access 01-12-2019 | Stroke | Research article

Stroke risk after transient ischemic attack in a Norwegian prospective cohort

Authors: Fredrik Ildstad, Hanne Ellekjær, Torgeir Wethal, Stian Lydersen, Janne Kutschera Sund, Hild Fjærtoft, Stephan Schüler, Jens Wilhelm Horn, Geir Bråthen, Ann-Grete Midtsæther, Åse Hagen Morsund, Marja-Liisa Lillebø, Yngve Müller Seljeseth, Bent Indredavik

Published in: BMC Neurology | Issue 1/2019

Abstract

Background

Transient ischemic attack (TIA) is a risk factor of stroke. Modern treatment regimens and changing risk factors in the population justify new estimates of stroke risk after TIA, and evaluation of the recommended ABCD² stroke risk score.

Methods

From October, 2012, to July, 2014, we performed a prospective, multicenter study in Central Norway, enrolling patients with a TIA within the previous 2 weeks. Our aim was to assess stroke risk at 1 week, 3 months and 1 year after TIA, and to determine the predictive value of the dichotomized ABCD² score (0–3 vs 4–7) at each time point. We used data obtained by telephone follow-up and registry data from the Norwegian Stroke Register.

Results

Five hundred and seventy-seven patients with TIA were enrolled of which 85% were examined by a stroke specialist within 24 h after symptom onset. The cumulative incidence of stroke within 1 week, 3 months and 1 year of TIA was 0.9% (95% CI, 0.37–2.0), 3.3% (95% CI, 2.1–5.1) and 5.4% (95% CI, 3.9–7.6), respectively. The accuracy of the ABCD² score provided by c-statistics at 7 days, 3 months and 1 year was 0.62 (95% CI, 0.39–0.85), 0.62 (95% CI, 0.51–0.74) and 0.64 (95% CI, 0.54–0.75), respectively.

Conclusions

We found a lower stroke risk after TIA than reported in earlier studies. The ABCD² score did not reliably discriminate between low and high risk patients, suggesting that it may be less useful in populations with a low risk of stroke after TIA.

Trial registration

Unique identifier: NCT02038725 (retrospectively registered, January 16, 2014).

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Title: Stroke risk after transient ischemic attack in a Norwegian prospective cohort
Authors: Fredrik Ildstad
Hanne Ellekjær
Torgeir Wethal
Stian Lydersen
Janne Kutschera Sund
Hild Fjærtoft
Stephan Schüler
Jens Wilhelm Horn
Geir Bråthen
Ann-Grete Midtsæther
Åse Hagen Morsund
Marja-Liisa Lillebø
Yngve Müller Seljeseth
Bent Indredavik
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Stroke
Carotid Stenosis
Carotid Stenosis
Published in: BMC Neurology / Issue 1/2019
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-018-1225-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Stroke risk after transient ischemic attack in a Norwegian prospective cohort

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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