Researchers from TIAregistry.org used the ASCOD (atherosclerosis, small vessel disease, cardiac pathology, other causes, dissection) rating system to evaluate the extent to which these underlying causes for a TIA or small cerebral infarction are simultaneously present and what their effect is on the 5-year risk of a major vascular event.
Between June 2009 and December 2011, 4,789 patients were enrolled at 61 sites in 21 countries. They had had a TIA or minor stroke (mRS score 0 or 1) in the previous 7 days. Of these, 3847 patients (mean 66.4 (SD 13.2) years; 59.7% male) completed the 5-year follow-up. The main outcome measure was the estimated 5-year risk of the composite outcome of stroke, acute coronary syndrome or cardiovascular death.
Of the 998 patients with probably or possibly causal atherosclerotic disease, 489 (49.0%) also had some form of small vessel disease (SVD), including 110 (11.0%) in whom lacunar stroke was also probably or possibly causal. ; 504 of them (50.5%) did not have SVD. In addition, 275 of these patients (27.6%) also had cardiac findings, including 225 (22.6%) in whom cardiac pathology was also likely or possibly causal; 702 patients (70.3%) had no cardiac findings.
Compared with patients without 1 of the 5 ASCOD categories (n = 484), the 5-year risk of major vascular events was almost 5 times higher (HR 4.86; p < 0.001) in patients with causal atherosclerosis; 2.5 times higher (HR 2.57; p < 0.001) in patients with causal lacunar stroke or lacunar syndrome and 4 times higher (HR 4.01; p < 0.001) in patients with causal cardiac pathology.
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2023-12-06 12:05:24
#Underlying #TIA #minor #stroke #influence #risk #vascular #event #MedNet
