Irish Medical Times
Friday, 2 December 2011
PATIENTS WITH A transient ischaemic attack (TIA) have a 20 per cent lower nine-year survival rate compared with the general population, new research shows, suggesting they may require the same intsense secondary prevents as MI patients.
After one year, 91.5 per cent of TIA patients were still alive, compared with 95 per cent in the general population, according to a study of over 22,000 adults hospitalised wit ha TIA in New South Wales, Australia, between 2000 and 2007.
After five years, survival was 13 per cent lower than expected, and after nine years the rate dropped to 20 per cent lower than the general population.
Women had higher survival rates than men, although the differences were not significant beyond one year. Older patients had poorer outcomes compared with the age- matched general population, particularly those over 65.
Other risk factors that most impacted survival rates were congestive heart failure, atrial fibrillation and prior hospitalisation for stroke.
“Our paper confirms that with current treatment, the long term mortality after TIA is very high,” said the authors. “While secondary prevention usually begins intensely, it is a challenge to maintain that level for years after a seemingly innocuous, but very dangerous, TIA.
“But the high long-term mortality suggest that TIA patients may require the intense secondary prevention we would use after heart attack.”
This included life-long anti-thrombotics and close follow-up to ensure good blood pressure control, cholesterol lowering and best management of diabetes, heart failure and atrial fibrillation, said the authors.
The study is one of the largest of its kind ever conducted and is the first to quantify the long-term effect of hospitalised TIA according to age, sex and medical history.