Rationale and Design of the Prevention of Cerebrovascular and Cardiovascular Events of Ischemic Origin with Terutroban in Patients with a History of Ischemic Stroke or Transient Ischemic Attack (PERFORM) Study

2009 ◽  
Vol 27 (3) ◽  
pp. 28-32 ◽  
Author(s):  
Michael G. Hennerici
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Cardiovascular Events ◽  
History Of ◽  
Ischemic Attack

scholarly journals Association of Parental History of Stroke With Clinical Parameters in Patients With Ischemic Stroke or Transient Ischemic Attack

Stroke ◽  
2003 ◽  
Vol 34 (9) ◽  
pp. 2114-2119 ◽  
Author(s):  
S. Tentschert ◽  
S. Greisenegger ◽  
R. Wimmer ◽  
W. Lang ◽  
W. Lalouschek
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Clinical Parameters ◽  
Parental History ◽  
History Of ◽  
Ischemic Attack

Early risk and predictors of cerebrovascular and cardiovascular events in transient ischemic attack and minor ischemic stroke

2012 ◽  
Vol 60 (2) ◽  
pp. 165 ◽  
Author(s):  
PN Sylaja ◽  
Raghunath Balakrishnan ◽  
Kesavadas Chandrasekharan ◽  
Mahesh Kate ◽  
JeyarajD Pandian ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Cardiovascular Events ◽  
Early Risk ◽  
Minor Ischemic Stroke ◽  
Ischemic Attack

scholarly journals Optimal Duration of Aspirin Plus Clopidogrel After Ischemic Stroke or Transient Ischemic Attack

Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 947-953 ◽  
Author(s):  
Hammad Rahman ◽  
Safi U. Khan ◽  
Fahad Nasir ◽  
Tehseen Hammad ◽  
Michael A. Meyer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Major Bleeding ◽  
Transient Ischemic Attack ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Controlled Trials ◽  
Short Term ◽  
All Cause Mortality ◽  
Ischemic Attack

Background and Purpose— The role of aspirin plus clopidogrel (A+C) therapy compared with aspirin monotherapy in patients presenting with acute ischemic stroke (IS) or transient ischemic attack remains uncertain. We conducted this study to determine the optimal period of efficacy and safety of A+C compared with aspirin monotherapy. Methods— Ten randomized controlled trials (15 434 patients) were selected using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) (inception June 2018) comparing A+C with aspirin monotherapy in patients with transient ischemic attack or IS. The primary efficacy outcome was recurrent IS, and the primary safety outcome was major bleeding. The secondary outcomes were major adverse cardiovascular events (composite of stroke, myocardial infarction, and cardiovascular mortality) and all-cause mortality. We stratified analysis based on the short- (≤1 month), intermediate- (≤3 month), and long-term (>3 month) A+C therapy. Effects were estimated as relative risk (RR) with 95% CI. Results— A+C significantly reduced the risk of recurrent IS at short-term (RR, 0.53; 95% CI, 0.37–0.78) and intermediate-term (RR, 0.72; 95% CI, 0.58–0.90) durations. Similarly, major adverse cardiovascular event was significantly reduced by short-term (RR, 0.68; 95% CI, 0.60–0.78) and intermediate-term (RR, 0.76; 95% CI, 0.61–0.94) A+C therapy. However, long-term A+C did not yield beneficial effect in terms of recurrent IS (RR, 0.81; 95% CI, 0.63–1.04) and major adverse cardiovascular events (RR, 0.87; 95% CI, 0.71–1.07). Intermediate-term (RR, 2.58; 95% CI, 1.19–5.60) and long-term (RR, 1.87; 95% CI, 1.36–2.56) A+C regimens significantly increased the risk of major bleeding as opposed to short-term A+C (RR, 1.82; 95% CI, 0.91–3.62). Excessive all-cause mortality was limited to long-term A+C (RR, 1.45; 95% CI, 1.10–1.93). Conclusions— Short-term A+C is more effective and equally safe in comparison to aspirin alone in patients with acute IS or transient ischemic attack.

Abstract TP418: Delayed Detection Of Atrial Fibrillation After Ischemic Stroke Or Transient Ischemic Attack

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Maria C Zurru ◽  
LAURA BRESCACIN ◽  
Claudia Alonzo ◽  
Victor Villarroel ◽  
Gabriela Orzuza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Recurrence Risk ◽  
Improvement Program ◽  
Profile Control ◽  
History Of ◽  
Ischemic Attack

Background and purpose: detection of atrial fibrillation (AF) after ischemic stroke is crucial, because anticoagulation is mandatory in order to decrease recurrence risk. However, there is no agreement regarding the optimal method to detect paroxysmal AF after the event. The aim of this study was to evaluate predictors for delayed detection of AF after ischemic stroke (IS) and transient ischemic attack (TIA). Methods: PROTEGE-ACV is a multidisciplinary stroke quality improvement program coordinated by internists and neurologists within a Buenos Aires healthcare system aimed to optimize secondary stroke preventive care after IS or TIA. Demographic data, vascular risk factors profile control and management were evaluated at the inclusion visit, and IS was categorized according to TOAST classification. Results: From 01/2007 to 04 /2012, 872 ischemic stroke patients were included; mean age was 75 ± 10 years-old and 55% were female. Twenty two percent were cardioembolic and 7% undetermined with more than one mechanism with AF as one of them; 14% of patients had history of AF or diagnosis at hospitalization. Incident AF was diagnosed in 101 (21%) of 473 patients with two or more years of follow-up.. Diagnosis of AF was associated with age older than 80 years (OR 1.96 95% CI 1.25-3), history of hypertension (OR 2.4 95% CI 1.25-4.8), chronic renal failure (OR 2.65 95% CI 1.54-4.55) and stroke recurrence (OR 2.96 95% CI 1.66-5.26). Conclusion: delayed diagnosis of AF was common in this cohort of patients with IS or TIA. Identification of risk factors is important in order to perform a close follow-up of these patients and to determine the best method for this purpose, in order to reduce recurrence risk.

Atherogenic Dyslipidemia and Residual Vascular Risk After Stroke or Transient Ischemic Attack

Stroke ◽  
2021 ◽  
Author(s):  
Takao Hoshino ◽  
Kentaro Ishizuka ◽  
Sono Toi ◽  
Takafumi Mizuno ◽  
Ayako Nishimura ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Cardiovascular Events ◽  
Density Lipoprotein ◽  
Annual Rate ◽  
Atherogenic Dyslipidemia ◽  
Major Adverse Cardiovascular Events ◽  
Intracranial Artery ◽  
Vascular Risk ◽  
Ischemic Attack

Background and Purpose: Notwithstanding the current guideline-based management, patients with stroke retain a substantial risk of further vascular events. We aimed to assess the contribution of atherogenic dyslipidemia (AD) to this residual risk. Methods: This was a prospective observational study, in which 792 patients (mean age, 70.1 years; male, 60.2%) with acute ischemic stroke (n=710) or transient ischemic attack (n=82) within 1 week of onset were consecutively enrolled and followed for 1 year. AD was defined as having both elevated levels of triglycerides ≥150 mg/dL and low HDL-C (high-density lipoprotein cholesterol) <40 mg/dL in men or <50 mg/dL in women, under fasting conditions. The primary outcome was a composite of major adverse cardiovascular events, including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death. Results: The prevalence of AD was 12.2%. Patients with AD more often had intracranial artery stenosis than those without (42.3% versus 24.1%; P =0.004), whereas no differences were observed in the prevalence of extracranial artery stenosis (17.7% versus 12.9%; P =0.62) or aortic plaques (33.3% versus 27.0%; P =0.87). At 1 year, patients with AD were at a greater risk of major adverse cardiovascular events (annual rate, 24.5% versus 10.6%; hazard ratio [95% CI], 2.33 [1.44–3.80]) and ischemic stroke (annual rate, 16.8% versus 8.6%; hazard ratio [95% CI], 1.84 [1.04–3.26]) than those without AD. When patients were stratified according to baseline LDL-C (low-density lipoprotein cholesterol) level, AD was predictive of major adverse cardiovascular events among those with LDL-C ≥100 mg/dL (n=509; annual rate, 20.5% versus 9.6%; P =0.036) as well as those with LDL-C <100 mg/dL (n=283; annual rate, 38.6% versus 12.4%; P <0.001). Conclusions: AD is associated with intracranial artery atherosclerosis and a high residual vascular risk after a stroke or transient ischemic attack. AD should be a promising modifiable target for secondary stroke prevention. REGISTRATION: URL: https://upload.umin.ac.jp ; Unique identifier: UMIN000031913.

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