Recurrent transient ischaemic attack and early risk of stroke: data from the PROMAPA study

Purroy, Francisco; Caballero, Jiménez; Gorospe, A A; Mj, Torres; Alvarez-Sabin, José; Santamarina, Esteban; Martínez-Sánchez, Patricia; Cánovas, David; Mj, Freijo; Egido, J.; Jm, Ramírez-Moreno; A, Alonso-Arias; Rodríguez-Campello, Ana; Casado, I.; Delgado‐Mederos, Raquel; Martí‐Fàbregas, Joan; Fuentes, Blanca; Y, Silva; Quesada, Helena; Cardona, Pere; Morales, A.; Ossa, de la; García-Pastor, Andrés; Jf, Arenillas; Segura, Tomás; Jiménez, Carmen; Masjuán, Jaime

doi:10.1136/jnnp-2012-304005

Cited by 40 publications

(30 citation statements)

References 31 publications

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“…Moreover, our study showed that large artery atherosclerosis was strongly associated with the risk of very early new TIA or stroke. Other studies identified this mechanism as an independent risk factor for recurrence at 7 day follow-up [12,13]. Similarly, the risk of recurrence at 7 days in patients with ischemic stroke was shown to be higher for those with large artery atherosclerosis [14].…”

Section: Discussionmentioning

confidence: 95%

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Factors associated with early recurrence at the first evaluation of patients with transient ischemic attack

Daubail

Durier

Jacquin

et al. 2014

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 95%

“…This choice was justified by the fact that it has been already well established that these patients are at high risk of early recurrence, and the decision-making about hospitalization is usually easy in routine practice [13,16].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with early recurrence at the first evaluation of patients with transient ischemic attack

Daubail

Durier

Jacquin

et al. 2014

Journal of Clinical Neuroscience

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“…Durante las últi mas décadas se han destinado enormes y esperan zadores esfuerzos en el tratamiento de la fase aguda del ictus isquémico para cambiar la historia natural de la enfermedad. La aprobación del tratamiento fibrinolítico dentro de las primeras cuatro horas y media del ictus, y la demostración de la seguridad y efectividad de las terapias mecánicas combinadas han revolucionado la actitud terapéutica en estos pacientes [25]. Sin embargo, más allá de la fase aguda existen ciertos aspectos que merecen tam bién atención y que mejoran el pronóstico y la cali dad de vida de estos pacientes, como el tratamiento rehabilitador, el tratamiento de prevención secun daria y el estado emocional.…”

Section: Introductionunclassified

Actualización de la depresión postictus: nuevos retos en pacientes con ictus minor o ataque isquémico transitorio

Carnes-Vendrell¹,

Deus-Yela²,

Molina-Seguin³

et al. 2016

RevNeurol

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Update on post-stroke depression: posing new challenges in patients with a minor stroke or transient ischaemic attack Introduction. Stroke is a leading cause of disability in adults. The development of depressive symptoms is the most common emotional complication. To date, most studies of post-stroke depression have excluded patients who have suffered a minor stroke or transient ischaemic attack (TIA), although they are equally vulnerable subgroups of this sickness. Aim. We present a review of published studies of post-stroke depression to elucidate aspects that have already been widely demonstrated and those who need more evidence. Development. The post-stroke depression is both frequent in patients with established stroke and minor stroke or TIA. Although there are discrepancies in the definition used, in up to one out of three patients will develop this complication. We have identified risk factors of post-stroke depression with a broad scientific background (female, history of depression or other psychiatric disorders, stroke severity, functional impairment) and other without it (quality of life, cognitive impairment and neuroimaging biomarkers). The main methodological limitations found are: confusion between poststroke depression and depressive symptoms; variability in rating scales used; and temporal variability in the time of the evaluation of mood. To date very few studies focused on minor stroke or TIA. Conclusions. Further studies are required with improved design in order to help establish the risk of post-stroke depression at different times after the stroke, minor stroke or TIA and the importance of all the factors described above.

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“…11 In addition, aggressive medical therapy may reduce the risk of recurrent stroke. Various modalities are used to detect extracranial and intracranial large-vessel atherosclerotic stenosis, including ultrasound, magnetic resonance angiography, and CT angiography (CTA).…”

Section: Vascular Imagingmentioning

confidence: 99%

Cryptogenic stroke

Yaghi

Elkind

2014

Neur Clin Pract

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SummaryCryptogenic, or unexplained, stroke is present in about 30%-40% of ischemic stroke patients. Pursuing a stroke mechanism is important in such patients to better choose therapy to reduce the stroke recurrence risk. Intracranial vessel imaging and cardiac evaluation with transesophageal echocardiogram and outpatient cardiac monitoring may help identify the stroke mechanism. This article highlights the diagnostic yield of various tests in identifying a stroke mechanism in stroke patients whose initial diagnostic evaluation is negative, and the implications for treatment.A 57-year-old man with an unremarkable medical history presented to the emergency room 5 days after the acute onset of left arm and hand weakness and numbness. He denied other neurologic symptoms. Blood pressure was 160/78 mm Hg and heart rate 78 and regular. General physical examination results were normal. He had mild dysarthria. Mental status and cranial nerve examination results were otherwise normal. He had mild weakness and reduced dexterity in the left hand, but cerebellar and sensory examinations, including graphesthesia and stereognosis, had normal results. ECG showed normal sinus rhythm. MRI showed a small cortical infarct in the right precentral gyrus (figure 1). Magnetic resonance angiography showed no major carotid or intracranial arterial stenosis. Inpatient telemetry did not show atrial fibrillation. Transthoracic echocardiography with agitated saline contrast suggested an intracardiac shunt, and transesophageal echocardiography confirmed the diagnosis of a patent foramen ovale (PFO) associated with an atrial septal aneurysm. A subsequent 21-day outpatient cardiac monitor did not show evidence of atrial fibrillation. He was treated with antiplatelet and statin therapy and referred for evaluation for participation in a randomized trial of interventional closure for PFO. BACKGROUNDIdentifying the stroke mechanism is a crucial aspect of secondary prevention of ischemic stroke. However, no stroke etiology is identified in 30%-40% of patients.1,2 Cryptogenic stroke is the term used to refer to strokes for which no definite cause can be identified.

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Recurrent transient ischaemic attack and early risk of stroke: data from the PROMAPA study

Abstract: According to our results, multiple TIAs within 7 days are associated with a greater subsequent risk of stroke than after a single TIA. Nevertheless, we found no independent predictor of stroke recurrence among these patients.

Cited by 40 publications

References 31 publications

Factors associated with early recurrence at the first evaluation of patients with transient ischemic attack

Factors associated with early recurrence at the first evaluation of patients with transient ischemic attack

Actualización de la depresión postictus: nuevos retos en pacientes con ictus minor o ataque isquémico transitorio

Cryptogenic stroke

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