Abstract
We are going on a multicenter prospective study to elucidate the incidence and predictors of subsequent ischemic stroke events in patients with transient ischemic attack (TIA). We conducted an interim analysis of this study. The study subjects were TIA patients within 7 days of TIA onset between June 2011 and December 2013 from a prospective register in 57 Japanese hospitals. The primary endpoint was subsequent ischemic stroke. A total of 1,075 patients were consecutively enrolled until 31 May 2013. Of these, 941 patients (622 men, 69.3 years) were followed at 90 days after TIA onset and were included in this study. Fifty-eight patients (6.2%) had subsequent ischemic strokes within 90 days of TIA onset. The leading subtype of the 58 ischemic strokes was lacunar infarction (n = 15) followed by atherothrombotic brain infarction (ATBI) attributable to intracranial artery disease (n = 11). As compared to patients without ischemic stroke, those with ischemic stroke more frequently had speech disturbance with hemiparesis and had higher systolic and diastolic blood pressure at presentation. The ABCD2 score tended to be higher in patients with ischemic stroke than those without it. Cox hazard multivariate analysis showed that speech disturbance with hemiparesis and systolic blood pressure at presentation were independently associated with ischemic stroke events. In conclusion, this interim analysis clarified the predictors of subsequent ischemic stroke after TIA, and demonstrated that the most common etiology of subsequent ischemic stroke was lacunar infarction followed by ATBI with intracranial artery disease.
