Hemostatic Activity in Patients with a Transient Ischemic Attack or Minor Ischemic Stroke with or without Chronic Non-Valvular Atrial Fibrillation

1993 ◽  
Vol 3 (6) ◽  
pp. 350-356
Author(s):  
Gheorghe A. Pop ◽  
Han J. Meeder ◽  
Wynsen van Oudenaarden ◽  
Jeannette C. van Latum ◽  
Wim Verweij ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Minor Ischemic Stroke ◽  
Hemostatic Activity ◽  
Ischemic Attack

scholarly journals Newly Diagnosed Atrial Fibrillation After Transient Ischemic Attack Versus Minor Ischemic Stroke in the POINT Trial

2021 ◽  
Vol 10 (6) ◽  
Author(s):  
Hooman Kamel ◽  
Mary Farrant ◽  
J. Donald Easton ◽  
Luciano A. Sposato ◽  
Jordan J. Elm ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Minor Stroke ◽  
Newly Diagnosed ◽  
Event Type ◽  
Primary Analysis ◽  
Index Event ◽  
Minor Ischemic Stroke ◽  
Ischemic Attack

Background Atrial fibrillation/flutter (AF) after transient ischemic attack (TIA) has not been well studied. We compared the likelihood of new AF diagnosis after ischemic stroke versus TIA. Methods and Results The POINT (Platelet‐Oriented Inhibition in New TIA and Minor Ischemic Stroke) trial enrolled adults within 12 hours of minor ischemic stroke or high‐risk TIA. Our exposure was index event type (ischemic stroke versus TIA). The primary analysis used the original trial definition of TIA (resolution of symptoms/signs). In secondary analyses, TIA cases with infarction on neuroimaging were reclassified as strokes. Our primary outcome was a new AF diagnosis, ascertained from adverse event and treatment interruption/discontinuation reports. We calculated C‐statistics for variables associated with newly diagnosed AF. We used Kaplan‐Meier survival statistics and Cox models adjusted for demographics and vascular risk factors. Excluding 49 subjects with baseline AF, 2746 patients had index stroke and 2086 patients had index TIA. During the 90‐day follow‐up, 106 patients had newly diagnosed AF. Cumulative risks of AF were 2.7% (95% CI, 2.1%–3.4%) after stroke and 2.0% (95% CI, 1.5%–2.7%) after TIA ( P =0.15). After reclassifying index events by neuroimaging, cumulative AF risk was higher after stroke (2.7%; 95% CI, 2.2%–3.4%) than TIA (1.8%; 95% CI, 1.3%–2.5%) ( P =0.04). Index event type had negligible predictive utility (C‐statistic, 0.54). Conclusions Among patients with cerebral ischemia, the distinction between TIA versus minor stroke did not stratify the risk of subsequent AF diagnosis, implying that patients with TIA should undergo similar heart‐rhythm monitoring strategies as patients with ischemic stroke.

Predictors of Major Vascular Events in Patients With a Transient Ischemic Attack or Minor Ischemic Stroke and With Nonrheumatic Atrial Fibrillation

Stroke ◽  
1995 ◽  
Vol 26 (5) ◽  
pp. 801-806 ◽  
Author(s):  
J.C. van Latum ◽  
P.J. Koudstaal ◽  
G.S. Venables ◽  
J. van Gijn ◽  
L.J. Kappelle ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Vascular Events ◽  
Minor Ischemic Stroke ◽  
Ischemic Attack

Clinical Effects of Dual Antiplatelet Therapy or Aspirin Monotherapy after Acute Minor Ischemic Stroke or Transient Ischemic Attack, a Meta-Analysis

2021 ◽  
Vol 27 ◽  
Author(s):  
Francesco Condello ◽  
Gaetano Liccardo ◽  
Giuseppe Ferrante
Keyword(s):  
Ischemic Stroke ◽  
Major Bleeding ◽  
Transient Ischemic Attack ◽  
Hemorrhagic Stroke ◽  
Dual Antiplatelet Therapy ◽  
Meta Analysis ◽  
Stroke Recurrence ◽  
Controlled Trials ◽  
Minor Ischemic Stroke ◽  
Ischemic Attack

Background: Evidence about the use of dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors in patients with acute minor ischemic stroke or transient ischemic attack (TIA) is emerging. The aim of our study was to provide an updated and comprehensive analysis about the risks and benefits of DAPT versus aspirin monotherapy in this setting. Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov databases, main international conference proceedings were searched for randomized controlled trials comparing DAPT versus aspirin monotherapy in patients with acute ischemic stroke or TIA not eligible for thrombolysis or thrombectomy presenting in the first 24 hours after the acute event. Data were pooled by meta-analysis using a random-effects model. The primary efficacy endpoint was ischemic stroke recurrence, and the primary safety outcome was major bleeding. Secondary endpoints were intracranial hemorrhage, hemorrhagic stroke, and all-cause death. Results: A total of 4 studies enrolling 21,459 patients were included. DAPT with clopidogrel was used in 3 studies, DAPT with ticagrelor in one study. DAPT duration was 21 days in one study, 1 month in one study, and 3 months in the remaining studies. DAPT was associated with a significant reduction in the risk of ischemic stroke recurrence (relative risk [RR], 0.74; 95% confidence interval [CI], 0.67-0.82, P<0.001, number needed to treat 50 [95% CI 40-72], while it was associated with a significantly higher risk of major bleeding (RR, 2.59; 95% CI 1.49-4.53, P=0.001, number needed to harm 330 [95% CI 149-1111]), of intracranial hemorrhage (RR 3.06, 95% CI 1.41-6.66, P=0.005), with a trend towards higher risk of hemorrhagic stroke (RR 1.83, 95% CI 0.83-4.05, P=0.14), and a slight tendency towards higher risk of all-cause death (RR 1.30, 95% CI 0.89-1.89, P=0.16). Conclusions: Among patients with acute minor ischemic stroke or TIA, DAPT, as compared with aspirin monotherapy, might offer better effectiveness in terms of ischemic stroke recurrence at the expense of a higher risk of major bleeding. The trade-off between ischemic benefits and bleeding risks should be assessed in tailoring the therapeutic strategies.

scholarly journals Corneal nerve and endothelial cell damage in patients with transient ischemic attack and minor ischemic stroke

PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0213319 ◽  
Author(s):  
Hoda Gad ◽  
Adnan Khan ◽  
Naveed Akhtar ◽  
Saadat Kamran ◽  
Ahmed El-Sotouhy ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endothelial Cell ◽  
Transient Ischemic Attack ◽  
Cell Damage ◽  
Endothelial Cell Damage ◽  
Minor Ischemic Stroke ◽  
Corneal Nerve ◽  
Ischemic Attack

scholarly journals Diagnostic Usefulness of the ABCD 2 Score to Distinguish Transient Ischemic Attack and Minor Ischemic Stroke From Noncerebrovascular Events

Stroke ◽  
2009 ◽  
Vol 40 (11) ◽  
pp. 3449-3454 ◽  
Author(s):  
Orla C. Sheehan ◽  
Aine Merwick ◽  
Lisa A. Kelly ◽  
Niamh Hannon ◽  
Michael Marnane ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Minor Ischemic Stroke ◽  
Diagnostic Usefulness ◽  
Ischemic Attack
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