Background: Many guidelines recommend urgent intervention for TIA patients with 2 or episodes within 7-days to reduce the early risk of stroke. However, whether all patients with multiple TIAs are at high early risk of stroke is unknown. Methods: Between April 2008 and December 2009, we included 1255 consecutive TIA patients from 30 Spanish stroke centers (PROMAPA study). We prospectively recorded clinical characteristics. We also determined the early short-term risk of stroke (at seven and ninety days). Aetiology of TIA was categorised using the SSS-TOAST classification Results: Enough information was assessed in 1137 patients (90.6%). 7-day and 90-day stroke risk were 2.6% and 3.8% respectively. Atherosclerotic etiology (AE) was confirmed in 190 (16.7%) patients. Recurrent TIA was observed in 274 (24,1%) patients. Duration<1 hour (OR 2.94, 95% CI 2.18-3.96, p<0.001), AE (OR 1.97, 95% CI 1.39-2.78, p<0.001) and motor weakness (OR 1.37, 95% CI 1.03-1.82, p<0.029) were independent predictors of recurrent TIA. The subsequent risks of stroke in these patients at 7, and 90 days were significantly higher than those after a single TIA (5.8% versus 1.5%, p<0.001 and 6.8% versus 3.0%, respectively. HR 2.35, 95% CI 1.28-4.31 p=0.006). In the Cox logistic regression model, among patients with recurrent TIA, no variable remained remained as independent predictors of stroke recurrence at 90-day Conclusion: According to our results, recurrent TIA within 7-days is associated with a greater subsequent stroke risk than after a single TIA. Nevertheless, we were not able to find any independent predictor of stroke recurrence among these patients.

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