Management of Atherothrombosis with Clopidogrel in High-Risk Patients with Recent Transient Ischaemic Attack or Ischaemic Stroke (MATCH): Study Design and Baseline Data

2003 ◽  
Vol 17 (2-3) ◽  
pp. 253-261 ◽  
Author(s):  
Hans-Christoph Diener ◽  
Julien Bogousslavsky ◽  
Lawrence M. Brass ◽  
Claudio Cimminiello ◽  
Laszlo Csiba ◽  
...  
Keyword(s):  
High Risk ◽  
Ischaemic Stroke ◽  
Study Design ◽  
Transient Ischaemic Attack ◽  
Baseline Data ◽  
High Risk Patients ◽  
Risk Patients ◽  
Ischaemic Attack

Transient Ischaemic Attack Care Pathway

2007 ◽  
Vol 11 (1) ◽  
pp. 11-15
Author(s):  
S Clare ◽  
S Kausar
Keyword(s):  
Health Care ◽  
High Risk ◽  
Acute Phase ◽  
Transient Ischaemic Attack ◽  
Care Pathway ◽  
Medical Emergency ◽  
Health Care Teams ◽  
Medical Encounter ◽  
Risk Patients ◽  
Ischaemic Attack

A transient ischaemic attack (TIA) is a common medical encounter, which is often managed suboptimally in the acute phase. A TIA should be treated as a medical emergency as studies have shown that high-risk patients can go on to have a stroke within seven days of a TIA. An audit was completed looking at referrals to the TIA clinic. Results prompted the production of a TIA care pathway, which prompted health-care teams on the appropriate management of these patients.

scholarly journals Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline

BMJ ◽  
2018 ◽  
pp. k5130 ◽  
Author(s):  
Kameshwar Prasad ◽  
Reed Siemieniuk ◽  
Qiukui Hao ◽  
Gordon Guyatt ◽  
Martin O’Donnell ◽  
...  
Keyword(s):  
High Risk ◽  
Ischaemic Stroke ◽  
Antiplatelet Therapy ◽  
Transient Ischaemic Attack ◽  
Dual Antiplatelet Therapy ◽  
Recurrent Stroke ◽  
Minor Stroke ◽  
Strong Recommendation ◽  
Ischaemic Attack

What is the role of dual antiplatelet therapy after high risk transient ischaemic attack or minor stroke? Specifically, does dual antiplatelet therapy with a combination of aspirin and clopidogrel lead to a greater reduction in recurrent stroke and death over the use of aspirin alone when given in the first 24 hours after a high risk transient ischaemic attack or minor ischaemic stroke? An expert panel produced a strong recommendation for initiating dual antiplatelet therapy within 24 hours of the onset of symptoms, and for continuing it for 10-21 days. Current practice is typically to use a single drug

scholarly journals Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2 score

2020 ◽  
pp. svn-2020-000372
Author(s):  
Shreyansh Shah ◽  
Li Liang ◽  
Durgesh Bhandary ◽  
Saga Johansson ◽  
Eric E Smith ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Ischaemic Stroke ◽  
Transient Ischaemic Attack ◽  
Intracranial Haemorrhage ◽  
Haemorrhagic Stroke ◽  
Medicare Beneficiaries ◽  
Ischaemic Attack

BackgroundLong-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack (TIA) and role of ABCD2 score in identifying high-risk individuals are not studied.MethodsWe identified 40 825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines (GWTG)-Stroke hospital and classified them using ABCD2 score. Proportional hazards models were used to assess 1-year event rates of mortality and rehospitalisation (all-cause, ischaemic stroke, haemorrhagic stroke, myocardial infarction, and gastrointestinal and intracranial haemorrhage) for high-risk versus low-risk groups adjusted for patient and hospital characteristics.ResultsOf the 40 825 patients, 35 118 (86%) were high risk (ABCD2 ≥4) and 5707 (14%) were low risk (ABCD2=0–3). Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%, 44.3% were rehospitalised for any reason and 3.6% were readmitted due to stroke. Patients with ABCD2 score ≥4 had higher mortality at 1 year than not (adjusted HR 1.18, 95% CI 1.07 to 1.30). Adjusted risks for ischaemic stroke, all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABCD2 score ≥4 vs 0–3. In contrast, haemorrhagic stroke, myocardial infarction, gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD2 score.ConclusionsThis study validates the use of ABCD2 score for long-term risk assessment after TIA in patients aged 65 years and older. Attentive efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.

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