What is the long-term prognosis for cerebral and cardiac events in patients with transient ischemic attacks or reversible ischemic neurologic deficits?
Patients with TIAs or RINDs have a high early risk of recurrent cerebral events and lower long-term survival compared to the general population, with cardiac disease and hypertension acting as significant predictors of mortality.
A hospital-based series of 712 patients with either transient ischemic attacks (TIAs) or reversible ischemic neurologic deficits (RINDs) was followed prospectively for 4 years in order to determine the long-term prognosis for cerebral and cardiac events in this group. The annual recurrence rates for new TIAs were 15.9, 5.3, 4.7 and 3.5 % in the 1st, 2nd, 3rd and 4th year, respectively, and the corresponding ones for fatal and nonfatal strokes were 3.37, 2.36, 1.7 and 1.3%. Strokes tended to occur in the 1st follow-up year (51%). The ratio of cerebral to cardiac deaths was 2.4. The survival of patients with RIND was similar to that of patients with TIA. Both survival rates were lower than those of an age- and sex-matched cohort sampled from the general population. Male gender emerged as a reliable predictor for cardiac events (p 60 years (p < 0.05), hypertension (p < 0.05) and cardiac disease (p < 0.001).
Carolei et al. (Wed,) studied this question.
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