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B.6 Long-term risk of subsequent stroke after transient ischemic attack or minor stroke: a systematic review and meta-analysis

Published online by Cambridge University Press:  24 May 2024

F Khan
Affiliation:
(Calgary)*
V Yogendrakumar
Affiliation:
(Melbourne)
R Lun
Affiliation:
(Palo Alto)
A Ganesh
Affiliation:
(Calgary)
V Lioutas
Affiliation:
(Boston)
N Vinding
Affiliation:
(Rigshospitalet)
A Algra
Affiliation:
(Utrecht)
C Weimar
Affiliation:
(Essen)
J Ögren
Affiliation:
(Östersund,)
J Edwards
Affiliation:
(Ottawa)
R Swartz
Affiliation:
(Toronto)
A Ois
Affiliation:
(Barcelona)
E Giralt-Steinhauer
Affiliation:
(Barcelona)
H Bae
Affiliation:
(Seoul)
M Kamouchi
Affiliation:
(Fukoka)
F de Leeuw
Affiliation:
(Nijmegen)
J Verhoeven
Affiliation:
(Nijmegen)
T Uehara
Affiliation:
(Himeji)
K Minematsu
Affiliation:
(Osaka)
S Fandler-Höfler
Affiliation:
(Graz)
M Foschi
Affiliation:
(L’Aquila)
W Whiteley
Affiliation:
(Edinburgh)
F Purroy
Affiliation:
(Lleida)
J Jing
Affiliation:
(Beijing)
Y Wang
Affiliation:
(Beijing)
M Baik
Affiliation:
(Seoul)
Y Kim
Affiliation:
(Seoul)
M Spampinato
Affiliation:
(Ferrara)
F Ildstad
Affiliation:
(Trondheim)
Y Hasegawa
Affiliation:
(Kawasaki)
K Perera
Affiliation:
(Hamilton)
H Park
Affiliation:
(Goyang)
D Dutta
Affiliation:
(Gloucester)
P Barber
Affiliation:
(Calgary)
S Coutts
Affiliation:
(Calgary)
M Hill
Affiliation:
(Calgary)
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Abstract

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Background: After a transient ischemic attack (TIA) or minor stroke, the long-term risk of subsequent stroke is uncertain. Methods: Electronic databases were searched for observational studies reporting subsequent stroke during a minimum follow-up of 1 year in patients with TIA or minor stroke. Unpublished data on number of stroke events and exact person-time at risk contributed by all patients during discrete time intervals of follow-up were requested from the authors of included studies. This information was used to calculate the incidence of stroke in individual studies, and results across studies were pooled using random-effects meta-analysis. Results: Fifteen independent cohorts involving 129794 patients were included in the analysis. The pooled incidence rate of subsequent stroke per 100 person-years was 6.4 events in the first year and 2.0 events in the second through tenth years, with cumulative incidences of 14% at 5 years and 21% at 10 years. Based on 10 studies with information available on fatal stroke, the pooled case fatality rate of subsequent stroke was 9.5% (95% CI, 5.9 – 13.8). Conclusions: One in five patients is expected to experience a subsequent stroke within 10 years after a TIA or minor stroke, with every tenth patient expected to die from their subsequent stroke.

Type
Abstracts
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation