Long-Term Incidence of Ischemic Stroke after Transient Ischemic Attack: A Nationwide Study from 2014 to 2020
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Long-Term Incidence of Ischemic Stroke after Transient Ischemic Attack : A Nationwide Study from 2014 to 2020. / Vinding, Naja Emborg; Butt, Jawad H.; Lauridsen, Marie Dam; Kristensen, Søren Lund; Johnsen, Søren Paaske; Krøll, Johanna; Graversen, Peter L.; Kruuse, Christina; Torp-Pedersen, Christian; Køber, Lars; Fosbøl, Emil L.
In: Circulation, Vol. 148, No. 13, 2023, p. 1000-1010.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Long-Term Incidence of Ischemic Stroke after Transient Ischemic Attack
T2 - A Nationwide Study from 2014 to 2020
AU - Vinding, Naja Emborg
AU - Butt, Jawad H.
AU - Lauridsen, Marie Dam
AU - Kristensen, Søren Lund
AU - Johnsen, Søren Paaske
AU - Krøll, Johanna
AU - Graversen, Peter L.
AU - Kruuse, Christina
AU - Torp-Pedersen, Christian
AU - Køber, Lars
AU - Fosbøl, Emil L.
N1 - Funding Information: This study was supported by an internal grant from Copenhagen University Hospital in Denmark. However, the foundation did not have any influence on the study design, data acquisition, data analysis, or preparation of the article, or any effect on the publication process. Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - epidemiology
KW - ischemic stroke
KW - stroke
KW - transient ischemic attack
U2 - 10.1161/CIRCULATIONAHA.123.065446
DO - 10.1161/CIRCULATIONAHA.123.065446
M3 - Journal article
C2 - 37622531
AN - SCOPUS:85172425817
VL - 148
SP - 1000
EP - 1010
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 13
ER -
ID: 396990701