Among patients who experienced a transient ischemic attack (TIA) or minor stroke, the rate of a composite of stroke, acute coronary syndrome, or death from cardiovascular causes is 12.9% at 5 years, with half of these events occurring in the second through fifth years.

In a study report published in the New England Journal of Medicine, Pierre Amarenco, MD, from Assistance Publique-Hôpitaux de Paris, and colleagues examined the 5-year risk of stroke and vascular events among patients who had had a TIA or minor stroke. Patients were followed for the primary outcome, with an emphasis on events occurring in the second to fifth years. A total of 3847 patients were included in the study.

The researchers found that the composite primary outcome occurred in 469 patients (estimated cumulative rate, 12.9%), with 50.1% of events occurring in the second through fifth years. Strokes had occurred in 345 patients at 5 years (estimated cumulative rate, 9.5%); 43.2% of these patients had a stroke during the second through fifth years. At 5 years, rates of death from any cause, death from cardiovascular causes, intra-cranial hemorrhage, and major bleeding were 10.6, 2.7, 1.1, and 1.5%, respectively.

“In a follow-up to a one-year study involving patients who had a TIA or minor stroke, the rate of cardiovascular events including stroke in a selected cohort was 6.4% in the first year and 6.4% in the second through fifth years,” the authors noted in conclusion.


REFERENCE:  Amarenco P, Lavallée PC, Monteiro Tavares L, et al. Five-Year Risk of Stroke after TIA or Minor Ischemic Stroke. N Eng J Med. 2018; 378:2182-2190.