Epidemiology of transient ischemic attack in the Normandy Stroke population-based study.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY European Stroke Journal Pub Date : 2024-12-01 Epub Date: 2024-05-06 DOI:10.1177/23969873241251722

Romain Schneckenburger, Marion Boulanger, Ahmad Nehme, Marguerite Watrin, Gwendoline Le Du, Sophie Guettier, Lydia Guittet, Emmanuel Touzé

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Abstract

Introduction: Transient ischemic attack (TIA) is a frequent neurological emergency which management and definition have changed radically over the last 15 years. However, recent epidemiological studies of TIA are scarce. We report here on the impact of the shift from a time-based to a tissue-based definition of TIA on its incidence and risk of recurrence in a new population-based cohort with a high rate of patients investigated by MRI.

Materials and methods: We prospectively included all TIAs that occurred between May 2017 and May 2021 from the Normandy Stroke Study, a population-based registry using multiple overlapping sources for exhaustive case identification in Caen la Mer area. TIAs were classified as either time-based (symptoms <24 h) or tissue-based (<24 h and no lesion on brain imaging). Attack and incidence rates were calculated, as was the 90-day ischemic stroke rate.

Results: Five hundred and sixty-seven TIAs (549 single patients) were included, with 80.6% having a brain MRI. Four hundred and ten (72.3%) met the definition of tissue-based TIA. The age standardized attack (to the 2013 European population) rate was 39.5 (95% CI 35.7-43.5) and the age-standardized incidence rate (first ever cerebrovascular event) was 29.7 (95% CI 27.3-34.2). The overall recurrent stroke rate at 90 days was 2.7%, with no difference between patients with or without ischemic lesions on MRI.

Conclusion: We found that the use of the tissue-based definition of TIA resulted in a 27.5% reduction in incidence as compared to the time-based definition, but had no impact on the 90-day stroke rate. The burden of TIA remains high, and is likely to increase as the population ages.

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诺曼底中风人群研究中短暂性脑缺血发作的流行病学。

简介：短暂性脑缺血发作（TIA）是一种常见的神经系统急症：短暂性脑缺血发作（TIA）是一种常见的神经系统急症，其治疗和定义在过去 15 年中发生了翻天覆地的变化。然而，近期关于 TIA 的流行病学研究却很少。我们在此报告了在一个新的人群队列中，从基于时间的 TIA 定义到基于组织的 TIA 定义的转变对其发病率和复发风险的影响：我们前瞻性地纳入了诺曼底卒中研究（Normandy Stroke Study）中2017年5月至2021年5月期间发生的所有TIA，该研究是一项基于人群的登记研究，采用多种重叠来源对Caen la Mer地区的病例进行了详尽的识别。TIA分为时间型（症状型）和非时间型（症状型）：共纳入 567 例 TIA（549 例单个患者），其中 80.6% 接受过脑磁共振成像检查。410例（72.3%）符合基于组织的TIA定义。年龄标准化发病率（2013 年欧洲人口）为 39.5（95% CI 35.7-43.5），年龄标准化发病率（首次脑血管事件）为 29.7（95% CI 27.3-34.2）。90 天内中风复发率为 2.7%，核磁共振成像有缺血性病变或无缺血性病变的患者之间没有差异：我们发现，与基于时间的定义相比，基于组织的 TIA 定义使发病率降低了 27.5%，但对 90 天的卒中率没有影响。TIA 的负担仍然很重，而且可能随着人口老龄化而增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.