The TIARegistry.org has released one-year follow-up data of its project “Reassessing Risks of Prognosis and Risk Stratification in Stroke and TIA” last week. The findings were published in the New England Journal of Medicine. The study found that the incidence of stroke recurrence can be lowered by evaluating and treating TIAs on an urgent basis in a large number of settings.

A number of studies have estimated the risk of recurrence after a transient ischemic attack (TIA). The TIA is also called a “mini-stroke” that occurs when the blood supply to the brain is briefly and mildly interrupted as a result of a blood clot formation in a blood vessel. Studies conducted between 1997-2003 noted the risk of recurrence within first three months of TIA to be around 12-20%.

Now that’s a three-month risk we are talking about up there, what about the long-term risk in such patients?

To answer the precise question, TIARegistry.org designed a study to reassess stroke prognosis and the risk of long-term i.e., one-year and five-year, recurrence in patients. Recently, the organization published their one-year follow-up data.

TIARegistry.org Project

The TIARegistry.org is an international, multicenter registry for patients who have had a recent episode of TIA. The current study will span over five years. Patients who wish to be a part of the project register through written or oral consent form. The study, aiming to estimate and compare the one-year and five-year risk of stroke in patients with a history of TIAs, is funded by Sanofi and Bristol-Myers Squibb.

The recent data released by the registry are prospective, investigation-driven and observational. The one-year follow-up included a total of 4,583 patients who were enrolled at 61 TIA clinics in 21 countries over the course of two and half  years. All patients were aged 18 and older and had had a TIA within seven days of registration. The risk stratification was done using Kaplan-Meier Method.

At one-year, the risk of stroke recurrence was 5.1% in these patients. The risk of fatal and non-fatal cardiovascular events was 6.2%. Compared to the cohorts in earlier studies, the risk of stroke recurrence at two days, seven days, 30 days, 90 days, and one year was less than half in the cohort i.e., 3.7% vs 12-20%. This was due mainly to the quick implementation of secondary stroke prevention strategies i.e., antiplatelet therapy, oral anticoagulation, antihypertensive therapy, and revascularization.

In simple words, the risk of stroke recurrence and cardiovascular complications is lower in patients with a history of TIAs who receive quick and appropriate care at the TIA clinics. The study reinforces the findings of previous studies, all of which vouch for an intensive and early treatment of TIAs with antithrombotic agents at the stroke specialist centers.

While stratifying the risk for the stroke recurrence, the study found a clear link between an ABCD2 score of 6 or 7, multiple obstructions to the blood flow (infarctions), and narrowing of the large artery due to plaque formation (large artery atherosclerosis), and the risk of stroke recurrence.

Risk Of Stroke — Study Limitations

It should be noted that the study was conducted on patients who received immediate and appropriate treatment for TIAs by stroke specialized physicians only.

Besides, data from more than 380 patients, out of 4,583 patients, was missing which could have affected the one-year event rate of the study.

What Is A Stroke?

A stroke is a medical emergency. Anyone having witnessed the condition firsthand knows the panic and scare it creates. A stroke, if not diagnosed and treated timely, can herald paralysis and death. The medical treatment for stroke must be instituted quickly otherwise brain cells begin to die within minutes of the attack.

A stroke is not something to be taken lightly. Its immediate management is important because even if an individual has survived the first episode, they remain at risk of a second attack. A stroke has a tendency to recur.

Stroke Facts And Statistics

  • Each year around 795,000 new cases of stroke are reported worldwide, out of which 600,000 constitute the first attack; the remaining 185,000 are recurrent attacks.
  • Stroke is the third leading cause of death in the United States i.e., killing 140,000 people each year.
  • Stroke, if not diagnosed and treated early, has the propensity to lead to a lifelong disability.
  • Stroke can occur at any age but the risk increases with age i.e., nearly 3/4th of all the strokes occur in individuals aged 65 and older.
  • Hypertension is the leading cause of stroke in most of the people.
  • A recently published research has found a link between loneliness and isolation and the risk of stroke in people.
  • People who smoke are twice at risk of an ischemic stroke – caused by a blood clot that blocks the blood vessels – than those who do not smoke.

Preventing Stroke

Regardless of your age, family history and medical condition, you can opt a number of measures to reduce the risk of developing a stroke. These include:

  • Controlling Your Blood Pressure (BP) – by regularly measuring your BP and taking antihypertensive medications. A reduced intake of salt is imperative for controlling the BP.
  • Losing Weight – obesity, while not a disease per se, is an open invitation to a number of diseases, one of which is stroke.
  • Treating Diabetes – high blood sugar damages blood vessels and increases the odds of blood clot formation.
  • Quitting Smoking – there is nothing charming about smoking. If you are health conscious, quitting smoking should be your first health goal.
  • Treating Atrial Fibrillation (AF) or Irregular Heartbeat – AF causes clot formation in the heart. The clots can dislodge from the heart and travel to the brain where they can partly or completely block a vessel leading to the stroke. If you have AF, get it treated.
  • Exercising Regularly – this may sound like a cliché but exercise is the best precaution against diseases and infections. Exercise increases blood flow to all parts of the body including the brain, thereby reducing chances of a stroke.