Cited by 676Acute Ischemic Stroke ManagementCerebrovascular and Carotid Artery DiseasesAcute Myocardial Infarction Research

Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis

Giles, Matthew F, Rothwell, Peter M·2007·The Lancet Neurology

Abstract

Background Stroke is often preceded by transient ischaemic attack (TIA), but studies of stroke risk after TIA are logistically difficult and have yielded conflicting results. However, reliable estimation of this risk is necessary for planning effective service provision, clinical trials, and public education. We therefore did a systematic review of all studies of stroke risk early after TIA.Methods All studies of stroke risk within 7 days of TIA were identified by use of electronic databases and by hand searches of reference lists, relevant journals, and conference abstracts. Stroke risks at 2 days and 7 days after TIA were calculated overall and analyses for heterogeneity were done, if possible, after categorisation by study method, setting, population, and treatment.Findings 18 independent cohorts were included, which reported stroke risk in 10 126 TIA patients. The pooled stroke risk was 5.2% (95% CI 3.9-6.5) at 7 days, but there was substantial heterogeneity between studies (p<0.0001), with risks ranging from 0% to 12.8%. However, the risks reported in individual studies over different durations of follow-up were highly correlated (0-7 days vs 8-90 days, r=0.89, p<0.0001), and the heterogeneity between studies was almost fully explained by study method, setting, and treatment. The lowest risks were seen in studies of emergency treatment in specialist stroke services (0.9% [95% CI 0.0-1.9], four studies) and the highest risks in population-based studies without urgent treatment (11.0% [8.6-13.5], three studies). Results were similar for stroke risk at 2 days.Interpretation The reported early risks of stroke after TIA were highly heterogeneous, but this could be largely accounted for by differences in study method, setting, and treatment, with lowest risks in studies of emergency treatment in specialist stroke services.

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Crossref · 10.1016/s1474-4422(07)70274-0

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Authors
Giles, M. F., & Rothwell, P. M.
Affiliations
University of Oxford (GB)
Corresponding author
Giles, Matthew F
Venue
The Lancet Neurology
Publisher
Elsevier BV
Published
2007-12
Volume
6
Issue
12
Pages
1063-1072
ISSN
1474-4422 (ISSN-L)
OpenAlex
W2165920141
Cited by
676
References
38
Citations by year
2026: 8 · 2025: 15 · 2024: 15 · 2023: 20 · 2022: 25 · 2021: 27 · 2020: 28 · 2019: 44 · 2018: 47 · 2017: 51 · 2016: 55 · 2015: 38 · 2014: 56 · 2013: 46 · 2012: 35
FWCI
4.74
Type
journal article
Language
en
Open access
closed
Locations
  • The Lancet Neurology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
transient ischemic attack, stroke risk, stroke prevention, study heterogeneity, follow-up duration
MeSH terms
Ischemic Attack, Transient, Humans, Risk, Time Factors, Meta-Analysis as Topic, Confidence Intervals, Databases, Factual, Stroke

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