Treatment of Minor Stroke Radically Reduces Major Stroke Risk

A new study has found that rapid assessment and treatment of a first transient ischemic attack (TIA) or minor ischemic stroke reduces risk for subsequent major stroke by about 80%.

Researchers from Bichat-Claude Bernard University Hospital (Paris, France) and Denis Diderot University and Medical School (Paris, France) followed 1,085 patients with suspected TIA between January 2003 and December 2005. The patients were assessed within 4 hours of admission with neurological, arterial, and cardiac imaging. Of these, 574 were seen within 24 hours of symptom onset; 701 had confirmed TIA or minor stroke, and 144 had possible TIA. Of the 643 patients with confirmed TIA, all began a stroke prevention program, with 43 individuals undergoing urgent carotid revascularization and 44 individuals treated for atrial fibrillation with anticoagulants. The study's primary outcome was stroke within 90 days.

At 90 days, the stroke rate was just 1.24%, which compared with an expected rate of 5.96%. According to the authors, this suggests immediate treatment through a dedicated clinic reduced the risk for recurrence of TIA by almost 80%. The study was published in the November 2007 issue of The Lancet Neurology.

"We show prompt evaluation and treatment of patients with TIA in a dedicated outpatient unit is associated with a lower than expected risk of subsequent stroke,” concluded lead author Pierre Amarenco, M.D, from Bichat-Claude Bernard University, and colleagues. "Because almost three-quarters of patients were discharged home on the same day as the diagnosis, the TIA clinic is also likely to involve lower costs and greater patient satisfaction about the management than is treatment without such a clinic.”

The study was conducted in a dedicated hospital clinic running what is known as the SOS-TIA program which provided 24-hour access specifically to assess and treat patients with suspected cerebral or retinal TIAs related to ischemia, and whose symptoms lasted less than 24 hours.


Related Links:
Bichat-Claude Bernard University Hospital
Denis Diderot University and Medical School