Long-term prognosis after transient ischemic attacks

Publisher Website
Google Scholar
Abstract
A follow-up study of 243 patients with transient ischemic attacks (TIA) is reported. The long-term mortality of the patients was higher than that of the corresponding general population. The excess mortality over the whole period of observation, irrespective of the age and sex of the patients, can be characterized by a single figure expressing the slope of the curve obtained by semilogarithmic plotting of the ratios of observed to expected survival against time. The use of this numerical expression, in the present series -0.04, facilitates comparisons of the survival of TIA patients drawn from different populations. Unfavorable prognostic factors were: carotid TIA, associated extracerebral disease and a history of hypertension. Fatal strokes, being 4 times as frequent as expected according to published incidence figures, accounted for 20% of the deaths, heart disease 38%. Stroke deaths tended to occur earlier than cardiac deaths. Most TIA like strokes, apparently are incidents in the progressive course of a generalized vascular disease. The excess mortality over the years following a TIA makes it difficult to recommend a discontinuation of prophylactic therapy at any particular time.