Prevalence, knowledge, and treatment of transient ischemic attacks in China

Wang, Wenjuan; Yue, Jiang; Li, H.; Wang, L.; Johnston, S. Claiborne; Liu, L.; Wong, Ka Sing; Wang, C.; Pan, Yuesong; Jing, Jian; Xu, Jin; Meng, Xia; Zhang, M.; Li, Y.; Zhou, Yifang; Zhao, Wenjuan; Wang, Y.

doi:10.1212/wnl.0000000000001665

Cited by 46 publications

(55 citation statements)

References 34 publications

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“…Our nationwide representative survey of Chinese adults suggests a high prevalence of hypertension in TIA patients, with an estimated 16.1 million TIA adults having had hypertension [13] , as well as low rates of selfawareness and successful control of the condition.…”

Section: Discussionmentioning

confidence: 90%

“…Patients and even physicians might not consider TIA to be as dangerous as strokes [13] ; however, TIA combined with hypertension [4] , particularly those that do not achieve the target of blood pressure control [10] , are ominous for subsequent strokes. Our current findings show that hypertension is severely under-diagnosed and under-controlled in TIA patients in China.…”

Section: Discussionmentioning

confidence: 99%

“…At each site, a multistage, complex sample survey design was used to select participants who were representative of Chinese civilian adults. Additional details on sub-district sampling and household selection for the CCDRFS study have been published previously [12,13] . A total of 98,658 people participated in the survey.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…The ascertainment of TIA was conducted through a 2-stage method [13] . The possible TIA cases were firstly identified by selfreported history and symptoms recalled through face-to-face questionnaire interviews by trained interviewers (medical professionals).…”

Section: Data Collectionmentioning

confidence: 99%

“…A TIA was confirmed by case review if the recalled symptoms were consistent with TIA as judged by the interviewing neurologist. Details of the diagnosis process of TIA cases have been previously published [13] . All the TIA cases, including documented TIA and TIA confirmed by a reviewing neurologist, were included in this analysis.…”

Section: Data Collectionmentioning

confidence: 99%

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Prevalence, Awareness and Control of Hypertension in Patients with Transient Ischemic Attacks in China

Pan

Zhao²,

Jiang³

et al. 2015

Neuroepidemiology

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Background: Hypertension is a major risk factor for stroke recurrence in patients with transient ischemic attacks (TIAs). The aim of this study was to estimate the prevalence, awareness, treatment and control rates of hypertension in Chinese adults with TIA. Methods: We analyzed data derived from the 2010 China Chronic Disease and Risk Factor Surveillance survey, a population-based study including a nationally representative sample of 2,780 Chinese adults with TIA. The national prevalence, awareness and control rates of hypertension in adults with TIA were estimated with weighted coefficients based on the 2010 China population census. Results: Among the 2,780 TIA patients, a total of 1,919 patients were identified as having hypertension. The estimated national prevalence of hypertension in TIA patients was 67.5% (95% CI 64.0-71.0). Among the hypertensive patients, 54.1% were aware of having hypertension and 8.3% was under control. Conclusions: Hypertension is severely under-diagnosed and under-controlled in patients with TIA in China. Appropriate strategies are urgently needed to improve the identification and control of hypertension in these patients.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Study Design and Participantsmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

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Prevalence, Awareness and Control of Hypertension in Patients with Transient Ischemic Attacks in China

Pan

Zhao²,

Jiang³

et al. 2015

Neuroepidemiology

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Association BetweenCYP2C19Loss-of-Function Allele Status and Efficacy of Clopidogrel for Risk Reduction Among Patients With Minor Stroke or Transient Ischemic Attack

Wang

Zhao

Lin

et al. 2016

JAMA

292

254

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IMPORTANCE Data are limited regarding the association between CYP2C19 genetic variants and clinical outcomes of patients with minor stroke or transient ischemic attack treated with clopidogrel. OBJECTIVE To estimate the association between CYP2C19 genetic variants and clinical outcomes of clopidogrel-treated patients with minor stroke or transient ischemic attack. DESIGN, SETTING, AND PARTICIPANTS Three CYP2C19 major alleles (*2, *3, *17) were genotyped among 2933 Chinese patients from 73 sites who were enrolled in the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) randomized trial conducted from January 2, 2010, to March 20, 2012. INTERVENTIONS Patients with acute minor ischemic stroke or transient ischemic attack in the trial were randomized to treatment with clopidogrel combined with aspirin or to aspirin alone. MAIN OUTCOMES AND MEASURESThe primary efficacy outcome was new stroke. The secondary efficacy outcome was a composite of new composite vascular events (ischemic stroke, hemorrhagic stroke, myocardial infarction, or vascular death). Bleeding was the safety outcome. RESULTS Among 2933 patients, 1948 (66.4%) were men, with a mean age of 62.4 years. Overall, 1207 patients (41.2%) were noncarriers and 1726 patients (58.8%) were carriers of loss-of-function alleles (*2, *3). After day 90 follow-up, clopidogrel-aspirin reduced the rate of new stroke in the noncarriers but not in the carriers of the loss-of-function alleles (P = .02 for interaction; events among noncarriers, 41 [6.7%] with clopidogrel-aspirin vs 74 [12.4%] with aspirin; hazard ratio [HR], 0.51 [95% CI, 0.35-0.75]; events among carriers, 80 [9.4%] with clopidogrel-aspirin vs 94 [10.8%] with aspirin; HR, 0.93 [95% CI, 0.69 to 1.26]). Similar results were observed for the secondary composite efficacy outcome (noncarriers: 41 [6.7%] with clopidogrel-aspirin vs 75 [12.5%] with aspirin; HR, 0.50 [95% CI, 0.34-0.74]; carriers: 80 [9.4%] with clopidogrel-aspirin vs 95 [10.9%] with aspirin; HR, 0.92 [95% CI, 0.68-1.24]; P = .02 for interaction). The effect of treatment assignment on bleeding did not vary significantly between the carriers and the noncarriers of the loss-of-function alleles (2.3% for carriers and 2.5% for noncarriers in the clopidogrel-aspirin group vs 1.4% for carriers and 1.7% for noncarriers in the aspirin only group; P = .78 for interaction). CONCLUSIONS AND RELEVANCE Among patients with minor ischemic stroke or transient ischemic attack, the use of clopidogrel plus aspirin compared with aspirin alone reduced the risk of a new stroke only in the subgroup of patients who were not carriers of the CYP2C19 loss-of-function alleles. These findings support a role of CYP2C19 genotype in the efficacy of this treatment.

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Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China

Yang

Wang

et al. 2021

JAMA Netw Open

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Key Points Question What are the contemporary clinical characteristics, management, and in-hospital outcomes in patients with acute stroke and transient ischemic attack in China? Findings In this quality improvement study that included more than 1 million admissions, in-hospital management measures and outcomes varied by type of cerebrovascular event and hospital level of care. Temporal improvements from 2015 to 2019 were also observed. Meaning Although improvements were seen over time, these findings suggest that ongoing support for evidence-based care is needed.

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Prevalence, knowledge, and treatment of transient ischemic attacks in China

Cited by 46 publications

References 34 publications

Prevalence, Awareness and Control of Hypertension in Patients with Transient Ischemic Attacks in China

Prevalence, Awareness and Control of Hypertension in Patients with Transient Ischemic Attacks in China

Association BetweenCYP2C19Loss-of-Function Allele Status and Efficacy of Clopidogrel for Risk Reduction Among Patients With Minor Stroke or Transient Ischemic Attack

Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China

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