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Stroke

Risk assessment to prevent recurrence after mild stroke or TIA

Nature Reviews Neurology volume 11, pages 131–133 (2015)Cite this article

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Stroke has a heavy socioeconomic burden. A subset of patients with transient or nondisabling cerebral ischaemic events will experience recurrent stroke, leading to permanent deficits. Two new studies tackle the challenge of identifying the patients most at risk for recurrent stroke via examination of radiological and serum biomarkers.

At least 15–30% of patients with stroke initially present with mild or transient symptoms.1 Transient ischaemic attacks (TIAs) and minor strokes represent an opportunity for diagnostic and therapeutic interventions aimed at prevention of stroke recurrence. Reorganizing care to include urgent evaluation for patients after TIA has been shown to reduce stroke recurrence by 80%.2 Yet, up to 10% of patients who have had a TIA or a minor stroke will develop symptom progression or a recurrent stroke.3

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References

  1. Rothwell, P. M. & Warlow, C. P. Timing of TIAs preceding stroke: time window for prevention is very short. Neurology 64, 817–820 (2005).

    Article  PubMed  Google Scholar 

  2. Rothwell, P. M. et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet 370, 1432–1442 (2007).

    Article  Google Scholar 

  3. Coutts, S. B. et al. What causes disability after transient ischemic attack and minor stroke? Results from the CT and MRI in the triage of TIA and minor cerebrovascular events to identify high risk patients (CATCH) study. Stroke 43, 3018–3022 (2012).

    Article  PubMed  Google Scholar 

  4. Johnston, S. C. et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 369, 283–292 (2007).

    Article  PubMed  Google Scholar 

  5. Merwick, A. et al. Addition of brain and carotid imaging to the ABCD2 score to identify patients at early risk of stroke after transient ischaemic attack: a multicentre observational study. Lancet Neurol. 9, 1060–1069 (2010).

    Article  PubMed  Google Scholar 

  6. Wasserman, J. K. et al. Computed tomography identifies patients at high risk for stroke after transient ischemic attack/nondisabling stroke. Prospective, multicenter cohort study. Stroke 46, 114–119 (2015).

    Article  PubMed  Google Scholar 

  7. Jové, M. et al. Metabolomics predicts stroke recurrence after transient ischemic attack. Neurology 84, 36–45 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Krol, A. L. et al. Incidence of radiocontrast nephropathy in patients undergoing acute stroke computed tomography angiography. Stroke 38, 2364–2366 (2007).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Poisson, S. N. et al. Intracranial large vessel occlusion as a predictor of decline in functional status after transient ischemic attack. Stroke 42, 44–47 (2011).

    Article  PubMed  Google Scholar 

  10. Lavallée, P. C. et al. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurol. 6, 953–960 (2007).

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

S.B.C. receives salary support from Alberta Innovates–Health Solutions and has received a Pfizer Cardiovascular award and grant funding from the Heart and Stroke Foundation of Canada, Genome Canada, Canadian Institute of Health Research.

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Affiliations

  1. Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, T2N 4N1, AB, Canada

    Amy Y. X. Yu & Shelagh B. Coutts

  2. Foothills Hospital, C1261, 1403 29th Street NW, Calgary, T2N 2T9, AB, Canada

    Shelagh B. Coutts

Authors
  1. Amy Y. X. Yu
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  2. Shelagh B. Coutts
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Corresponding author

Correspondence to Shelagh B. Coutts.

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The authors declare no competing financial interests.

Additional information

Wasserman, J. K. et al. Stroke 46, 114–119 (2015) | Jové, M. et al. Neurology 84, 36–45 (2015)

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Yu, A., Coutts, S. Risk assessment to prevent recurrence after mild stroke or TIA. Nat Rev Neurol 11, 131–133 (2015). https://doi.org/10.1038/nrneurol.2015.16

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  • DOI: https://doi.org/10.1038/nrneurol.2015.16

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