Cardioembolic TIA was associated with a higher rate of subsequent acute ischemic stroke compared to non-cardioembolic TIA (10% vs 5%; aHR 1.76, 95% CI 1.06-2.94).
Cohort (n=1,478)
No
Does cardioembolic etiology increase the risk of acute ischemic stroke, MACE, and mortality compared to non-cardioembolic etiology in patients with TIA?
Cardioembolic TIA is associated with significantly higher risks of subsequent acute ischemic stroke, MACE, and mortality compared to non-cardioembolic TIA, highlighting the need for intensified secondary prevention.
Effect estimate: aHR 1.76 (95% CI 1.06-2.94)
Absolute Event Rate: 10% vs 5%
Abstract Background and aims Cardioembolic acute ischemic stroke (AIS) are known to have a higher risk of recurrent events than AIS of other etiology. The evidence is inconclusive for transient ischemic attack (TIA). Our study aimed to assess the association between cardioembolic TIA and the occurrence of AIS, major adverse cardiovascular event (MACE) and overall mortality in the follow-up. Methods We retrospectively identified TIA patients treated at our center between 2015 and 2020. We used Cox regression to evaluate the association between cardioembolic TIA, compared to non-cardioembolic TIA, and the occurrence of outcome events after TIA. MACE was defined as the occurrence of AIS, TIA, non-fatal coronary event, or cardiovascular death. Results Of 1478 TIA patients included, 15% (n=238) had a cardioembolic etiology. Patients with cardioembolic TIA were older (80 years versus 70 years), had more often a prior stroke, arterial hypertension, and they were more likely to smoke. The mean follow-up time was 29 days for cardiovascular events and 1638 days for mortality. The main cardioembolic source was atrial fibrillation (87%). An AIS occurred more often in the cardioembolic TIA group (10% versus 5%). After adjustment for sex, ABCD2-Score, and prior stroke, cardioembolic TIA was associated with higher rate of AIS (adjusted hazard ratio aHR 1.76, 95% confidence interval CI 1.06–2.94), increased occurrence of MACE (aHR 1.54, 95% CI 1.10–2.15), and overall mortality (aHR 2.34, 95% CI 1.76–3.11). Conclusions Cardioembolic TIA are associated with poorer outcomes. Closer monitoring and intensified secondary prevention is warranted in this subgroup. Conflict of interest All of the authors have nothing to disclose
Birner et al. (Fri,) conducted a cohort in Transient Ischemic Attack (TIA) (n=1,478). Cardioembolic TIA vs. Non-cardioembolic TIA was evaluated on Acute ischemic stroke (AIS) (aHR 1.76, 95% CI 1.06-2.94). Cardioembolic TIA was associated with a higher rate of subsequent acute ischemic stroke compared to non-cardioembolic TIA (10% vs 5%; aHR 1.76, 95% CI 1.06-2.94).