Abstract P652: Burden of Vascular Events Amongst TIA Patients - A Nationwide Estimate

Abstract

Introduction: Literature reported, 9-17% transient ischemic attack (TIA) patients have a vascular event within 90 days but there is limited data on long term risk involvement of vascular events following TIA. Aim: To identify prevalence and association of cardiovascular diseases (CVD) and cerebrovascular disorders (CeVD) amongst early and late TIA. Methods: We performed a retrospective cross-sectional analysis of Nationwide Inpatient Sample (2016-2017) in adults hospitalizations. Early TIA (primary diagnosis), late TIA (secondary diagnosis-within a year) and vascular events [CVD (AFib, IHD, acute MI angina) and CeVD (AIS, ICeH, SAH)] amongst TIA were identified using ICD 10 CM codes. Prevalence of vascular events were compared amongst patients with TIA and without TIA. Weighted analysis to account for sampling strategy using mix-effect multivariable survey logistic regression was performed to evaluate odds of having vascular events amongst TIA in comparison to non-TIA. Results: Amongst 58,259,589 US hospitalizations, 0.38% and 5.92% patients had early and late TIA, respectively. Patients with late TIA had higher prevalence of acute MI (4.9 vs 0.5 vs 3.4%), IHD (44 vs 28.6 vs 20.6%), angina (0.3 vs 0.2 vs 0.2%), AFib (22 vs 15.3 vs 10.9%), AIS (5.3 vs 0.6 vs 2%), SAH (0.2 vs 0.03 vs 0.1%) and ICeH (0.8 vs 0.04 vs 0.4%) compared to early TIA and no-TIA, respectively. (p<.0001) Patients with late TIA had 23% higher risk of having Afib [aOR 1.23; 95%CI 1.22-1.23] and higher odds of having IHD [1.52; 1.52-1.53], AIS [1.72; 1.70-1.74], and ICeH [1.29; 1.25-1.33]. (Table 1) Conclusion: We found a higher prevalence of late TIA amongst US hospitalizations. Additionally, late TIA patients had a higher risk of vascular events like Afib, IHD, and stroke. Hence, a thorough clinical investigation and long term followup of TIA patients may mitigate the risk of future vascular events and associated health care burden.