Factors influencing the survival of 451 transient ischemic attack patients.

Abstract

Four hundred fifty-one patients with transient ischemic attacks (TIA) occurring within 1 month of hospitalization, admitted during 1977-1983, were analyzed to establish the effect on survival of age, race, sex, distribution of TIA, cigarette smoking, previous cerebral infarction or hemorrhage, previous TIA, or history of ischemic heart disease, valvular heart disease, cardiac dysrhythmia, hypertension, and diabetes mellitus. Proportional hazards analysis revealed that decreased survival was associated with increasing age, carotid artery distribution TIAs (compared with vertebrobasilar distribution TIAs), cigarette smoking, previous contralateral stroke, ischemic heart disease, and diabetes mellitus. We found great variation in the estimated survival of TIA patients, ranging from 5-year survivals of > 95% for 60-year-old patients with none of these risk factors to < 25% for patients with all of these risk factors. Although the survival of the strata differed, the average mortality rates for this series of patients was about one-half of that observed for 225 patients accessed and followed by our center during 1961-1973. (Stroke 1987;18:552-557)

Cerebral infarction verified by cranial computed tomography and prognosis for survival following transient ischemic attack.

“…2 Although prognosis has apparently improved since the late 1960s, 3 the fate of individual patients depends heavily on their age, smoking history, and pattern of concurrent diseases. 4 Cranial computed tomography (CT) reveals a cerebral infarct in 10-40% of TTA patients, even in the absence of a clinical history of stroke. 5 In 1983, Waxman and Toole 6 suggested that the prognosis of TIA patients with CT-verified infarcts differed from that of other TIA patients.…”

Reevaluation of transient ischemic attacks as a risk factor for early mortality.

“…We have shown previously 8 in our TIA cohort that patients with none of these risk factors, and even TIA patients with a single risk factor, fare as well as the age-, race-, and sex-matched general population. In contrast, those TIA patients with two or more of these risk factors have survival estimates that are clearly less than that of the general population.…”

“…In the case of the TIA registry, a standard questionnaire assessing traditional and nontraditional risk factors for cerebrovascular and coronary heart disease, including smoking behavior and history of hypertension and diabetes, was administered by trained interviewers during hospitalization, with methods detailed elsewhere. 8 Data for the catheterization registry were collected using a standard questionnaire assessing similar traditional cardiovascular risk factors. Patient report was used to establish a history of hypertension, diabetes, ischemic heart disease, previous stroke, and cigarette smoking.…”

“…Because the National Death Index began monitoring in 1979, we excluded TLA patients from our previously reported series 8 who were admitted before that date, resulting in a TIA study cohort of 338 patients (accrued between 1979 and 1984). Details of their accrual are available in these previous publications.…”

“…However, based on data from the Cooperative Study of Transient Ischemic Attacks 9 and our own TIA population, 8 TIA patients have a significantly higher prevalence of cerebrovascular and coronary heart disease risk factors, including hypertension, ischemic heart disease, diabetes, cigarette smoking, and previous stroke, than is present in the general population. We have shown previously 8 in our TIA cohort that patients with none of these risk factors, and even TIA patients with a single risk factor, fare as well as the age-, race-, and sex-matched general population.…”