A study of short term and long term risk of ischemic stroke and other vascular events following early treatment of tia and minor stroke in a tertiary centre in North India

Abstract

Transient ischemic attack and minor ischemic stroke are associated with early recurrence and deterioration respectively. There is a high risk of stroke after TIA ranging between 10-20% in the ensuing 90 days in the various studies. There are various clinical and imaging factors which predict the early risk of stroke after a TIA. To evaluate the short term and long term risk of ischemic stroke following early treatment of TIA and minor stroke. TIA is defined as sudden focal neurologic deficit of presumed vascular origin lasting less than 24 hours. Minor ischemic stroke is defined as National institute of Health Stroke scale score of ≤5. TIA mimics were excluded from the study. The patients were followed up till 1 year. In patients with minor ischemic stroke, a 2-point worsening in the NIHSS was considered as an event. Modified Rankin score at 3 months was assessed. Total 320 patients were analysed with a mean age of 60.6 ± 13.6 years. Out of the them 20.7% were females, 78% of patients had minor stroke. There is significant association of lacunar stroke in minor stroke patients (p<0.01), whereas most TIA patients, etiology remained undetermined. In multiple regression analysis, both diabetes [p<0.05] and significant vessel stenosis (>50%) [p<0.05] were found to be an independent predictor of recurrent stroke in TIA and minor stroke patients. Urgent treatment after TIA and minor ischemic stroke is associated with reduced risk of ischemic stroke recurrence. Both diabetes mellitus and significant vessel stenosis are independent predictor of stroke recurrence.