Long-Term Incidence of Ischemic Stroke After Transient Ischemic Attack : A Nationwide Study From 2014 to 2020
BACKGROUND: The short-term incidence of ischemic stroke after a transient ischemic attack (TIA) is high. However, data on the long-term incidence are not well known but are needed to guide preventive strategies.
METHODS: Patients with first-time TIA (index date) in the Danish Stroke Registry (January 2014-December 2020) were included and matched 1:4 with individuals from the background population and 1:1 with patients with a first-time ischemic stroke on the basis of age, sex, and calendar year. The incidences of ischemic stroke and mortality from index date were estimated by Aalen-Johansen and Kaplan-Meier estimators, respectively, and compared between groups using multivariable Cox regression.
RESULTS: We included 21 500 patients with TIA, 86 000 patients from the background population, and 21 500 patients with ischemic stroke (median age, 70.8 years [25th-75th percentile, 60.8-78.7]; 53.1% males). Patients with TIA had more comorbidities than the background population, yet less than the control stroke population. The 5-year incidence of ischemic stroke after TIA (6.1% [95% CI, 5.7-6.5]) was higher than the background population (1.5% [95% CI, 1.4-1.6], P<0.01; hazard ratio, 5.14 [95% CI, 4.65-5.69]) but lower than the control stroke population (8.9% [95% CI, 8.4-9.4], P<0.01; hazard ratio, 0.58 [95% CI, 0.53-0.64]). The 5-year mortality for patients with TIA (18.6% [95% CI, 17.9-19.3]) was higher than the background population (14.8% [95% CI, 14.5-15.1], P<0.01; hazard ratio, 1.26 [95% CI, 1.20-1.32]) but lower than the control stroke population (30.1% [95% CI, 29.3-30.9], P<0.01; hazard ratio, 0.41 [95% CI, 0.39-0.44]).
CONCLUSIONS: Patients with first-time TIA had an ischemic stroke incidence of 6.1% during the 5-year follow-up period. After adjustment for relevant comorbidities, this incidence was approximately 5-fold higher than what was found for controls in the background population and 40% lower than for patients with recurrent ischemic stroke.
| Errataetall: |
CommentIn: Circulation. 2024 Mar 5;149(10):797-798. - PMID 38437480 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:148 |
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| Enthalten in: |
Circulation - 148(2023), 13 vom: 26. Sept., Seite 1000-1010 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Vinding, Naja Emborg [VerfasserIn] |
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| Links: |
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| Themen: |
Epidemiology |
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| Anmerkungen: |
Date Completed 27.09.2023 Date Revised 03.04.2024 published: Print-Electronic CommentIn: Circulation. 2024 Mar 5;149(10):797-798. - PMID 38437480 Citation Status MEDLINE |
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| doi: |
10.1161/CIRCULATIONAHA.123.065446 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361207816 |
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| 100 | 1 | |a Vinding, Naja Emborg |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-Term Incidence of Ischemic Stroke After Transient Ischemic Attack |b A Nationwide Study From 2014 to 2020 |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 27.09.2023 | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Circulation. 2024 Mar 5;149(10):797-798. - PMID 38437480 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The short-term incidence of ischemic stroke after a transient ischemic attack (TIA) is high. However, data on the long-term incidence are not well known but are needed to guide preventive strategies | ||
| 520 | |a METHODS: Patients with first-time TIA (index date) in the Danish Stroke Registry (January 2014-December 2020) were included and matched 1:4 with individuals from the background population and 1:1 with patients with a first-time ischemic stroke on the basis of age, sex, and calendar year. The incidences of ischemic stroke and mortality from index date were estimated by Aalen-Johansen and Kaplan-Meier estimators, respectively, and compared between groups using multivariable Cox regression | ||
| 520 | |a RESULTS: We included 21 500 patients with TIA, 86 000 patients from the background population, and 21 500 patients with ischemic stroke (median age, 70.8 years [25th-75th percentile, 60.8-78.7]; 53.1% males). Patients with TIA had more comorbidities than the background population, yet less than the control stroke population. The 5-year incidence of ischemic stroke after TIA (6.1% [95% CI, 5.7-6.5]) was higher than the background population (1.5% [95% CI, 1.4-1.6], P<0.01; hazard ratio, 5.14 [95% CI, 4.65-5.69]) but lower than the control stroke population (8.9% [95% CI, 8.4-9.4], P<0.01; hazard ratio, 0.58 [95% CI, 0.53-0.64]). The 5-year mortality for patients with TIA (18.6% [95% CI, 17.9-19.3]) was higher than the background population (14.8% [95% CI, 14.5-15.1], P<0.01; hazard ratio, 1.26 [95% CI, 1.20-1.32]) but lower than the control stroke population (30.1% [95% CI, 29.3-30.9], P<0.01; hazard ratio, 0.41 [95% CI, 0.39-0.44]) | ||
| 520 | |a CONCLUSIONS: Patients with first-time TIA had an ischemic stroke incidence of 6.1% during the 5-year follow-up period. After adjustment for relevant comorbidities, this incidence was approximately 5-fold higher than what was found for controls in the background population and 40% lower than for patients with recurrent ischemic stroke | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a ischemic stroke | |
| 650 | 4 | |a stroke | |
| 650 | 4 | |a transient ischemic attack | |
| 700 | 1 | |a Butt, Jawad H |e verfasserin |4 aut | |
| 700 | 1 | |a Lauridsen, Marie Dam |e verfasserin |4 aut | |
| 700 | 1 | |a Kristensen, Søren Lund |e verfasserin |4 aut | |
| 700 | 1 | |a Johnsen, Søren Paaske |e verfasserin |4 aut | |
| 700 | 1 | |a Krøll, Johanna |e verfasserin |4 aut | |
| 700 | 1 | |a Graversen, Peter L |e verfasserin |4 aut | |
| 700 | 1 | |a Kruuse, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Torp-Pedersen, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Køber, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a Fosbøl, Emil L |e verfasserin |4 aut | |
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