Five-year prognosis after TIA or minor ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Five-year prognosis after TIA or minor ischemic stroke in Asian and non-Asian countries.
Author(s) :
Hoshino, Takao [Auteur]
Uchiyama, Shinichiro [Auteur]
Kitagawa, Kazuo [Auteur]
Tokyo Women's Medical University [TWMU]
Charles, Hugo [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Lavallée, Philippa C. [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Albers, Gregory W. [Auteur]
Stanford Medicine
Caplan, Louis R. [Auteur]
Harvard Medical School [Boston] [HMS]
Donnan, Geoffrey A. [Auteur]
University of Melbourne
Ferro, José M. [Auteur]
Hennerici, Michael G. [Auteur]
Universität Heidelberg [Heidelberg] = Heidelberg University
Molina, Carlos [Auteur]
Rothwell, Peter M. [Auteur]
University of Oxford
Gabriel Steg, Philippe [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Touboul, Pierre-Jean [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Vicaut, Eric [Auteur]
Hôpital Lariboisière
Amarenco, Pierre [Auteur]
CIC - CHU Bichat
Uchiyama, Shinichiro [Auteur]
Kitagawa, Kazuo [Auteur]
Tokyo Women's Medical University [TWMU]
Charles, Hugo [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Lavallée, Philippa C. [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Albers, Gregory W. [Auteur]
Stanford Medicine
Caplan, Louis R. [Auteur]
Harvard Medical School [Boston] [HMS]
Donnan, Geoffrey A. [Auteur]
University of Melbourne
Ferro, José M. [Auteur]
Hennerici, Michael G. [Auteur]
Universität Heidelberg [Heidelberg] = Heidelberg University
Molina, Carlos [Auteur]
Rothwell, Peter M. [Auteur]
University of Oxford
Gabriel Steg, Philippe [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Touboul, Pierre-Jean [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Vicaut, Eric [Auteur]
Hôpital Lariboisière
Amarenco, Pierre [Auteur]
CIC - CHU Bichat
Journal title :
Neurology
Abbreviated title :
Neurology
Publication date :
2020-10-17
ISSN :
1526-632X
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Objective
To determine long-term vascular outcomes of Asian patients who experienced TIA or minor ischemic stroke and to compare the outcomes of Asian patients with those of non-Asian patients, in the context of modern ...
Show more >Objective To determine long-term vascular outcomes of Asian patients who experienced TIA or minor ischemic stroke and to compare the outcomes of Asian patients with those of non-Asian patients, in the context of modern guideline-based prevention strategies. Methods This is a subanalysis of the TIAregistry.org project, in which 3,847 patients (882 from Asian and 2,965 from non-Asian countries) with a recent TIA or minor ischemic stroke were assessed and treated by specialists at 42 dedicated units from 14 countries and followed for 5 years. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome. Results No differences were observed in the 5-year risk of the primary outcome (14.0% vs 11.7%; hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.88–1.37; p = 0.41) and stroke (10.7% vs 8.5%; HR, 1.17; 95% CI, 0.90–1.51; p = 0.24) between Asian and non-Asian patients. Asian participants were at higher risk of intracranial hemorrhage (1.8% vs 0.8%; HR, 2.23; 95% CI, 1.09–4.57; p = 0.029). Multivariable analysis showed that the presence of multiple acute infarctions on initial brain imaging was an independent predictor of primary outcome and modified Rankin Scale score of >1 in both Asian (HR, 1.91; 95% CI, 1.11–3.29; p = 0.020) and non-Asian (HR, 1.39; 95% CI, 1.02–1.90; p = 0.037) patients. Conclusion The long-term risk of vascular events in Asian patients was as low as that in non-Asian patients, while Asian participants had a 2.2-fold higher intracranial hemorrhage risk. Multiple acute infarctions were independently associated with future disability in both groups. Classification of Evidence This study provides Class I evidence that among people who experienced TIA or minor stroke, Asian patients have a similar 5-year risk of cardiovascular death, stroke, and acute coronary syndrome as non-Asian patients.Show less >
Show more >Objective To determine long-term vascular outcomes of Asian patients who experienced TIA or minor ischemic stroke and to compare the outcomes of Asian patients with those of non-Asian patients, in the context of modern guideline-based prevention strategies. Methods This is a subanalysis of the TIAregistry.org project, in which 3,847 patients (882 from Asian and 2,965 from non-Asian countries) with a recent TIA or minor ischemic stroke were assessed and treated by specialists at 42 dedicated units from 14 countries and followed for 5 years. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome. Results No differences were observed in the 5-year risk of the primary outcome (14.0% vs 11.7%; hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.88–1.37; p = 0.41) and stroke (10.7% vs 8.5%; HR, 1.17; 95% CI, 0.90–1.51; p = 0.24) between Asian and non-Asian patients. Asian participants were at higher risk of intracranial hemorrhage (1.8% vs 0.8%; HR, 2.23; 95% CI, 1.09–4.57; p = 0.029). Multivariable analysis showed that the presence of multiple acute infarctions on initial brain imaging was an independent predictor of primary outcome and modified Rankin Scale score of >1 in both Asian (HR, 1.91; 95% CI, 1.11–3.29; p = 0.020) and non-Asian (HR, 1.39; 95% CI, 1.02–1.90; p = 0.037) patients. Conclusion The long-term risk of vascular events in Asian patients was as low as that in non-Asian patients, while Asian participants had a 2.2-fold higher intracranial hemorrhage risk. Multiple acute infarctions were independently associated with future disability in both groups. Classification of Evidence This study provides Class I evidence that among people who experienced TIA or minor stroke, Asian patients have a similar 5-year risk of cardiovascular death, stroke, and acute coronary syndrome as non-Asian patients.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T07:59:55Z
2023-12-11T09:08:17Z
2023-12-11T09:08:17Z