Incidence of Transient Ischemic Attack in Auckland, New Zealand, in 2011 to 2012

Barber, P. Alan; Krishnamurthi, Rita; Parag, Varsha; Anderson, Neil E.; Ranta, Annemarei; Kilfoyle, Dean; Wong, Edward; Green, Geoff; Arroll, Bruce; Bennett, Derrick; Witt, Emma; Rush, Elaine; Suh, Flora Minsun; Theadom, Alice; Rathnasabapathy, Yogini; Ao, Braden Te; Parmar, Priya; Feigin, Valery L.

doi:10.1161/strokeaha.116.014010

Cited by 18 publications

(25 citation statements)

References 27 publications

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“…Comparisons with previous studies are limited because of the paucity of available information, and variations in the population are used for age standardizations. Only a few population-based studies reported the incidence of TIA (first-ever event) during the 2000s, with rates (standardized to the 2013 European population) ranging from 17 to 73/100,000/year [2-6]. These results are consistent with our present study (age-standardized rate: 61/100,000/year), which covered a more recent period of ascertainment.…”

Section: Discussionsupporting

confidence: 91%

“…Although most studies restricted their analyses to first-ever TIA, a few reported data on recurrent events, but the definition of recurrence that was applied differed between studies. For example, in the Auckland study, recurrent TIA was defined as a TIA event that occurred 28 days after the index event [2]. With this definition, recurrent TIA accounted for 6.8% of patients overall.…”

Section: Discussionmentioning

confidence: 99%

“…Knowledge is especially limited with regard to recent years [2-6], even though major changes in preventive medications have taken place over the last decade. Reliable information on TIA incidence is, however, of a major importance so as to evaluate current and future needs for dedicated care facilities, and to design clinical trials targeting this population.…”

Section: Introductionmentioning

confidence: 99%

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Contemporary Epidemiology of Transient Ischemic Attack in Dijon, France (2013–2015)

Béjot¹,

Brenière²,

Graber³

et al. 2017

Neuroepidemiology

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Background: We aimed to evaluate the epidemiological features of transient ischemic attack (TIA). Methods: All TIAs were prospectively collected in Dijon, France, using a population-based registry (2013–2015). TIAs were considered the first-ever in patients who had no previous cerebrovascular events (CVEs); otherwise they were considered recurrent TIAs. Annual incidence (first-ever TIAs) and attack rates (first-ever and recurrent TIAs) were calculated. Results: Four hundred twenty TIAs were registered (255 first-ever and 165 recurrent TIAs, mean age: 74.1 ± 15.7 years). The age-standardized incidence rate (to the 2013 European population) was 61 (95% CI 46–76) and the attack rate was 81 (95% CI 64–99) per 100,000/year. Patients with TIA as a recurrent event had a greater prevalence of risk factors and preventive treatments. However, one third of them were not receiving antithrombotic agents or antihypertensive treatments, and half were not treated with statins at the time of their recurrence. The mean ABCD² score was 4.3 ± 1.3, and 72% of patients had a high risk of recurrence (score ≥4). In patients with available MRI (23%), an infarct lesion was seen in 15.5%. Conclusions: TIA is a frequent occurrence and a large proportion of patients have a high risk of recurrence, thus highlighting the need to establish dedicated emergency services to administer prompt secondary prevention.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contemporary Epidemiology of Transient Ischemic Attack in Dijon, France (2013–2015)

Béjot¹,

Brenière²,

Graber³

et al. 2017

Neuroepidemiology

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“…The annual incidence of tia in the UK is estimated at 0.51 per 1000 population, 3 0.80 in Spain, 4 0.37-1.1 in the United States (US) 5 and 0.40 in New Zealand. 6 accurate diagnosis is important, as the early identification and treatment of tia substantially reduces patients' risk of subsequent stroke and consequent disability and mortality. 7 additionally, in France, it was reported that early assessment and management of tia and minor stroke resulted in ~80% reduction of recurrent stroke at 3 months from initial tia.…”

mentioning

confidence: 99%

Diagnosis and management of transient ischemic attacks in primary care: a systematic review

2017

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INTRODUCTION:Many patients who suffer a transient ischaemic attack (TIA) present to their general practitioner (GP). Early identification and treatment reduces the risk of subsequent stroke, disability and mortality. AIM:To review the accuracy of TIA diagnosis in primary care, immediate management and interventions to assist GPs with the condition. METHODS:This study included the search of Medline, Embase, Web of Science and Scopus databases . Relevant titles and abstracts were obtained using structured criteria (diagnosis, immediate management or intervention of TIAs in primary care), with full review and data extraction for eligible publications.TWo reviewers independently assessed quality and extracted information from the 24 eligible studies. The studies had heterogeneous methodology rendering meta-analysis inappropriate, so a narrative synthesis was undertaken. RESULTS:Most studies found limitations in GPs' knowledge and ability to diagnose TIAs to varying extent over time and between countries. GPs tended to over-interpret non-specific symptoms (e.g. isolated vertigo) when considering a TIA diagnosis. Reported referral behaviour varied between countries, with some favouring admission and others preferring outpatient management. Consistent under-referral and under-use of effective medication was reported. However, GPs may refer some patients to exclude rather than confirm a final diagnosis. This, alongside evidence of under-referral, suggests the need for education and decision support tools to enhance referral patterns. Intervention studies suggested that electronic decision support may increase referrals and timely management.CONCLUSION: This review revealed deficiencies in knowledge and clinical practice, and identified potential avenues to addressing these. Issues for future research were also identified.

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“…Stroke, which includes ischemic stroke and hemorrhagic stroke, is one of the fatal or disabling cerebral vascular diseases [1,2]. Ischemic stroke accounts for over 80% of the total incidences of stroke.…”

Section: Introductionmentioning

confidence: 99%

Limb Remote Ischemic Postconditioning Reduces Ischemia-Reperfusion Injury by Inhibiting NADPH Oxidase Activation and MyD88-TRAF6-P38MAP-Kinase Pathway of Neutrophils

Chen

Zhang

et al. 2016

IJMS

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Limb remote ischemic postconditioning (LRIP) has been confirmed to reduce the ischemia-reperfusion injury but its mechanisms are still not clear. This study clarified the mechanism of LRIP based on the nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase and Myeloid differentiation factor 88 (MyD88)-Tumor necrosis factor (TNF) receptor-associated factor 6 (TRAF6)-P38 pathway of neutrophils. Rat middle cerebral artery occlusion (MCAO) model was used in this study. Ischemia-reperfusion injury was carried out by MCAO 1.5 h followed by 24 h reperfusion. LRIP operation was performed to the left femoral artery at 0, 1 or 3 h after reperfusion. Behavioral testing, including postural reflex test, vibrissae-elicited forelimb placing test and tail hang test, showed that LRIP operated at 0 h of reperfusion could significantly ameliorate these behavioral scores. Pathological examinations, infarct size, Myeloperoxidase (MPO) activity showed that LRIP operated at 0 h of reperfusion could significantly ameliorate the pathological scores, reduce the infarct size and MPO activity in the brain and increase the MPO activity in the left leg. By using Neutrophil counting, immunofluorescence and real-time PCR techniques, we found that LRIP operated at 0 h of reperfusion could reduce neutrophil counts in the peripheral blood and downregulate the activation of neutrophil in the peripheral blood and rat brain. Western blots revealed that MyD88, TRAF6, p38 mitogen-activated protein kinase (p38-MAPK) in neutrophils and the phosphorylation of p47phox (Ser 304 and Ser 345) in neutrophil could be downregulated by LRIP. Our study suggests that LRIP inhibits the number and activation of neutrophils in the rat brain and peripheral blood linked to down-regulating the activation of NADPH oxidase in neutrophils by MyD88/TRAF6/p38-MAPK pathway.

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Incidence of Transient Ischemic Attack in Auckland, New Zealand, in 2011 to 2012

Cited by 18 publications

References 27 publications

Contemporary Epidemiology of Transient Ischemic Attack in Dijon, France (2013–2015)

Contemporary Epidemiology of Transient Ischemic Attack in Dijon, France (2013–2015)

Diagnosis and management of transient ischemic attacks in primary care: a systematic review

Limb Remote Ischemic Postconditioning Reduces Ischemia-Reperfusion Injury by Inhibiting NADPH Oxidase Activation and MyD88-TRAF6-P38MAP-Kinase Pathway of Neutrophils

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