Differences in characteristics and outcomes between Asian and non-Asian patients in the TIAregistry.org

• Verfasst von: Hoshino, Takao [VerfasserIn]
• Verfasst von: Hennerici, Michael G. [VerfasserIn]
• Titel: Differences in characteristics and outcomes between Asian and non-Asian patients in the TIAregistry.org
• Verf.angabe: Takao Hoshino, MD; Shinichiro Uchiyama, MD; Lawrence K.S. Wong, MD; Leila Sissani, BS; Gregory W. Albers, MD; Natan M. Bornstein, MD; Louis R. Caplan, MD; Geoffrey A. Donnan, MD; José M. Ferro, MD; Michael G. Hennerici, MD; Julien Labreuche, BS; Philippa C. Lavallée, MD; Carlos Molina, MD; Peter M. Rothwell, MD; Philippe Gabriel Steg, MD; Pierre-Jean Touboul, MD; Éric Vicaut, MD; Pierre Amarenco, MD; on behalf of the TIAregistry.org Investigators
• E-Jahr: 2017
• Jahr: June 5, 2017
• Umfang: 9 S.
• Fussnoten: Gesehen am 28.05.2018
• Titel Quelle: Enthalten in: Stroke
• Ort Quelle: New York, NY : Association, 1970
• Jahr Quelle: 2017
• Band/Heft Quelle: 48(2017), 7, Seite 1779-1787
• ISSN Quelle: 1524-4628
• DOI: doi:10.1161/STROKEAHA.117.016874
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: ischemic stroke
• Sach-SW: population
• Sach-SW: prognosis
• Sach-SW: race and ethnicity
• Sach-SW: transient ischemic attack
• K10plus-PPN: 1575541920

Abstract

Background and Purpose: This study provides the contemporary causes and prognosis of transient ischemic attack (TIA) and minor stroke in Asians and the direct comparisons with non-Asians. Methods: The TIAregistry.org enrolled 4789 patients (1149 Asians and 3640 non-Asians) with a TIA or minor ischemic stroke within 7 days of onset. Every participating facility had systems dedicated to urgent intervention of TIA/stroke patients by specialists. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome. Results: Approximately 80% of patients were evaluated within 24 hours of symptom onset. At 1 year, there were no differences in the rates of composite cardiovascular events (6.8% versus 6.0%; P=0.38) and stroke (6.0% versus 4.8%; P=0.11) between Asians and non-Asians. Asians had a lower risk of cerebrovascular disease (stroke or TIA) than non-Asians (adjusted hazard ratio, 0.79; 95% confidence interval, 0.63-0.98; P=0.03); the difference was primarily driven by a lower rate of TIA in Asians (4.2% versus 8.3%; P<0.001). Moderately severe bleeding was more frequent in Asians (0.8% versus 0.3%; P=0.02). In multivariable analysis, multiple acute infarcts (P=0.005) and alcohol consumption (P=0.02) were independent predictors of stroke recurrence in Asians, whereas intracranial stenosis (P<0.001), ABCD2 score (P<0.001), atrial fibrillation (P=0.008), extracranial stenosis (P=0.03), and previous stroke or TIA (P=0.03) were independent predictors in non-Asians. Conclusions: The short-term stroke risk after a TIA or minor stroke was lower than expected when urgent evidence-based care was delivered, irrespective of race/ethnicity or region. However, the predictors of stroke were different for Asians and non-Asians.