Long‐term risk of stroke and its predictors in transient ischaemic attack patients in Germany

Abstract

Background and purpose Little is known about the long‐term association between transient ischaemic attack (TIA) and stroke. Therefore, the goal of this study was to analyze the long‐term risk of stroke and associated predictors in a large cohort of TIA patients followed in general practices in Germany. Methods This study included patients with an initial TIA diagnosis and subsequently followed up in one of 1262 general practices in Germany between January 2007 and December 2016 (N = 19 824 patients). The primary outcome of the study was the risk of ischaemic stroke within 10 years of the initial diagnosis of TIA. The secondary outcome was the identification of demographic, clinical and pharmaceutical variables significantly associated with stroke in TIA patients. Results Within 10 years of the initial TIA diagnosis, 18.3% of individuals were diagnosed with stroke. Age was positively associated with stroke, with hazard ratios ranging from 1.88 in patients aged 51–60 years to 4.00 in those aged >80 years (reference group: patients aged ≤50 years). Furthermore, male sex, hypertension, diabetes mellitus, atrial fibrillation and ischaemic heart diseases had an additional impact on the risk of stroke. Finally, new oral anticoagulants, heparins, diuretics, angiotensin II receptor blockers and platelet aggregation inhibitors were identified as protective factors. Conclusions In a cohort of almost 20 000 TIA patients, 18.3% were diagnosed with stroke within 10 years after the TIA index event. Several demographic, clinical and pharmaceutical variables significantly predicted the long‐term risk of stroke in TIA patients.

Long term survival after a first transient ischaemic attack in England: A retrospective matched cohort study

“…The current study also found that cases had more vascular incidents at follow-up than controls (recurrent TIAs, strokes and myocardial infarctions). The relative hazards of death were a little higher than previously reported 8,16,21 . Hence, our study suggests that TIA should not be considered as a 'minor' neurological condition.…”

“…Some previous studies were often limited by small sample sizes [17][18] or short follow-up periods 19 . Furthermore, comparison of their results was limited due to methodological differences: prospective [16][17] versus retrospective follow-up 8,20 , the source of participants: hospital based 8,16 versus community based 15,18,21 , by stroke etiology, recruitment period and non-adjustment of confounding factors.…”

Pulmonary hypertension is associated with an increased incidence of cancer diagnoses

“… 9 Rathmann et al demonstrated good agreement between the outpatient DA database with German reference data with respect to the incidence or prevalence of cancer diagnoses. 9 Finally, this database has already been used in previous studies focusing on cardiovascular disorders 10 , 11 as well as cancer. 12 , 13 …”

Delirium: Prevalence and outcome in the very old in 27 medical departments during a one-year prospective study

“…Thus, studies describing the prevalence rates in patients aged ≥65 years were considered. Men have been found to be at a higher risk for developing delirium (1) and other diseases (Angele et al, 2014; Jacob et al, 2019). This also applies to patients aged ≥65 years.…”