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61. High-resolution diffusion-weighted imaging identifies ischemic lesions in a majority of transient ischemic attack patients. (PubMed)

presented with DWI lesions. These patients had higher National Institute of Health Stroke Scale and ABCD2 scores and presented more frequently with vessel occlusion and perfusion deficits, but had similar functional outcome at 3 months. Taken together, high-resolution DWI provides evidence of ischemic brain injury in the majority of TIA patients. ANN NEUROL 2019;86:452-457.© 2019 The Authors. Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association.

2019 Annals of Neurology

62. Is Transient Ischemic Attack a Medical Emergency? OHTAC Recommendation

, where patients can be evaluated and treated urgently, results in lower rates of stroke and disability than conventional treatment. About half of strokes following TIA occur within the first 48 hours; therefore, patients with TIA should be evaluated as early as possible within 24 hours of first call to medical attention. Patients at high risk of stroke may require admission to a stroke unit for further evaluation and appropriate treatment. This review showed that patients with an ABCD2 score of 4 (...) or higher have significantly higher rates of stroke or recurrent TIA if they receive standard treatment and are discharged from an ED, compared to patients who are hospitalized. This may indicate that higher-risk patients need more comprehensive, intensive investigation and management than lower-risk patients. At the same time, this analysis identified limitations to the use of ABCD2 risk scores in assessing which patients are at higher risk of stroke. ABCD2 risk scores do not reflect the absence

2015 Health Technology Assessment (HTA) Database.

63. Heart Disease and Stroke Statistics?2016 Update

attributable to sodium intake >2.0 g/d, representing nearly 1 in 10 (9.5%) of all CVD deaths. Between 2003 and 2012, certain aspects of diet quality improved in the United States, including increases in whole grains and reductions in sugar-sweetened beverages. The prevalence of both children and adults meeting the dietary goals improved between 2003 to 2004 and 2011 to 2012. The prevalence of ideal levels of diet (healthy diet score >80) increased from 0.2% to 0.6% in children and from 0.7% to 1.5 (...) % in adults. During this period, the proportion of youths aged 5 to 19 years with poor scores on the dietary metric for cardiovascular health decreased steadily from 69.2% to 54.6%, whereas for adults, the decrease was from 50.3% to 41.0%. Although healthier diets cost modestly more than unhealthful diets, comparing extremes of unhealthful versus healthful food-based diet patterns, the more healthful patterns cost on average ≈$1.50 per day more. Similarly priced options are also common; in a comparison

2014 American Heart Association

64. Reducing time-to-unit among patients referred to an outpatient stroke assessment unit with a novel triage process: a prospective cohort study. (PubMed)

for effective triage as medical intervention for true TIA/minor stroke is time-sensitive and TIA unit spots are a finite resource.Prospective cohort study design utilizing patient referral data and TIA unit arrival times from a regional fast-track TIA unit on Vancouver Island, Canada, accepting referrals from emergency departments (ED) and general practice (GP). Historical referral cohort (N = 2942) from May 2013-Oct 2014 was triaged using the ABCD2 score; prospective referral cohort (N = 2929) from Nov (...) 2014-Apr 2016 was triaged using the novel system. A retrospective survival curve analysis, censored at 28 days to unit arrival, was used to compare days to unit arrival from event date between cohort patients matched by low (0-3), moderate (4-5) and high (6-7) ABCD2 scores.Survival curve analysis indicated that using the novel triage system, prospectively referred TIA/minor stroke patients with low and moderate ABCD2 scores arrived at the unit 2 and 1 day earlier than matched historical patients

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2018 BMC health services research

65. PRediction of Acute Coronary Syndrome in Acute Ischemic StrokE

with acute ischemic stroke admitted to the participating sites will be systematically screened for eligibility Criteria Inclusion Criteria: diagnosis of ischemic stroke based on clinical and imaging information (CT or MRI) diagnosis of transient ischemic attack if the initial focal neurological deficit has been examined by a neurologist and if the ABCD2-score is ≥ 4 Elevation of high-sensitive cardiac troponins according to the rule-in/rule-out algorithm of the 2015 ESC guidelines for NSTE-ACS, i.e (...) during the stay in hospital as well as after three and twelve months functional outcome [ Time Frame: at baseline, at one week and at three and twelve months after the initial event ] functional outcome will be evaluated using the modified Rankin scale (0-6 with greater scores indicating poorer functional outcome) cognitive outcome during inpatient stay [ Time Frame: at baseline and at one week after the initial event ] cognitive outcome will be evaluated using the Montreal Cognitive Assessment

2018 Clinical Trials

66. Antiplatelet vs R-tPA for Acute Mild Ischemic Stroke

with alteplase for acute ischemic stroke within 4.5 hours from stroke onset. Minor stroke is usually defined as NIHSS score ≤ 3 or 5,although it accounts for 1/2-2/3 of AIS, the evidence of thrombolysis is insufficient. A study from Canada shows that 28.5% of patients with minor stroke who have not receive rt-pa thrombolytic therapy are unable to walk independently when discharged. Based on such a consideration,the PRISMS study further compares the efficacy and safety of thrombolytic therapy (...) even if the patient's condition has worsened, is clinically more puzzling. The CHANCE study in 2013 shows that the efficacy of aspirin with clopidogrel is superior to aspirin alone with minor stroke (NIHSS < 3) or TIA(ABCD2 < 4). The POINT study in 2018 further confirmed the efficacy and safety of intensive antithrombotic therapy within 12 hours of onset with minor stroke. Based on the above discussion, this study aims to explore the efficacy and safety of aspirin with clopidogrel vs alteplase

2018 Clinical Trials

67. Safety and Efficacy of RIC in Pediatric Moyamoya Disease Patients Treated With Revascularization Therapy

intervention [ Time Frame: within 7days after RIC treatment ] The investigator will record the number. The score of ABCD2 [ Time Frame: change from baseline (pre‑RIC treatment) at 180 days after revascularization therapy ] We use this scale to evaluate the patients' risk of stroke who with TIA .The score of the scale ranges from 0 to 7, and the higher score indicates higher risk of stroke in the patients who with TIA.The scale will be assessed by qualified investigator who are blinded to the treatment (...) from baseline(pre-RIC treatment) at 180 days after revascularization therapy ] cerebral perfusion status in the operation side at 6 months posttreatment as assessed by single photon emission computed tomography (SPECT). Secondary Outcome Measures : The score of National Institute of Health stroke scale score [ Time Frame: change from baseline (preoperation) at 24 hours, 48 hours, 72 hours, and at 5-7 days or if discharged earlier ] National Institute of Health Stroke Scale (NIHSS) is considered

2018 Clinical Trials

68. Empowerment and Mobile Technology in the Control of Cardiovascular Risk Factors in Patients With Ischemic Stroke

deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 40 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Ischemic stroke or transient ischemic attack (ABCD2 score ≥3) Age ≥40 years Informed consent from the patient or legal representative

2018 Clinical Trials

69. ED Referral Dramatically Reduces Delays of Initial Evaluation in a French TIA Clinic (PubMed)

years (+/-18). Median (IQR) ABCD2 score was 3 (2-4). Median (IQR) delay from onset to evaluation was 8 h (4-48). Overall, 185 (52%) were referred by OBP vs. 169 (48%) by ED. Evaluation was initiated within 12 h among 201 (57%) patients. After logistic regression, OBP referral was by comparison with ED the only independent factor associated with an evaluation delay >12 h (OR 5.7, 95% CI: 3.5-9.3, p < 0.0001). Conclusion: Our results suggest that preliminary assessment by OBP may increase the delay

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2018 Frontiers in neurology

70. Transient Ischaemic Attack Rarely Precedes Stroke in a Cohort with Low Proportions of Large Artery Atherosclerosis: A Population-Based Study (PubMed)

strokes, 16% (95% confidence interval [CI] 12-22) were from LAA. Of 258 ischaemic stroke patients, only 11 (4%; 95% CI 2-7) reported symptoms in the preceding 90 days consistent with TIA. Nine (82%) sought medical attention. The median ABCD2 score in this group was 4.5 (IQR: 3-7), and the median time of event prior to stroke was 20 days (IQR: 4-32).In our population-based cohort, rates of TIA preceding ischaemic stroke were much lower than previously reported, probably reflective of effective

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2018 Cerebrovascular Diseases Extra

71. Pragmatic trial of multifaceted intervention (STROKE-CARD care) to reduce cardiovascular risk and improve quality-of-life after ischaemic stroke and transient ischaemic attack -study protocol. (PubMed)

multi-domain secondary prevention, systematic detection and treatment of post-stroke complications, and patient self-empowerment. Enrolment of 2160 patients with acute ischaemic stroke or TIA (ABCD2-Score ≥ 3) is planned at two study centres in Austria. The co-primary efficacy endpoints are (i) the composite of major recurrent cardiovascular events (nonfatal stroke, nonfatal myocardial infarction, and vascular death) occurring within 12 months after the index event and (ii) one-year health-related

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2018 BMC Neurology

72. Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack. (PubMed)

administrative data to identify admission rates and chart review data to identify ABCD2 scores (a tool to classify stroke risk after TIA).Providers' decisions to admit TIA patients were related to uncertainty in several domains: lack of a facility TIA-specific policy, inconsistent use of ABCD2 score, and concerns about facilities' ability to complete a timely workup. There was a disconnect between staff perceptions about TIA admission and facility admission rates. According to chart review data, staff (...) at facilities with higher admission rates in FY 2011 reported consistent reliance on ABCD2 scores and related guidelines in admission decision-making.Many factors contributed to decisions regarding admitting a patient with TIA; however, clinicians' uncertainty appeared to be a key driver. Further quality improvement interventions for TIA care should focus on facility adoption of TIA protocols to address uncertainty in TIA admission decision-making and to standardize timely evaluation of TIA patients

2018 Journal of General Internal Medicine

73. Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial. (PubMed)

by conferring dual antiplatelet effect during a high-risk period for subsequent stroke. Therefore, we explored the efficacy and safety of ticagrelor versus aspirin in the patients who received any aspirin the week before randomization.A prespecified subgroup analysis in SOCRATES (n=13 199), randomizing patients with acute ischemic stroke (National Institutes of Health Stroke Scale score of ≤5) or transient ischemic attack (ABCD2 score of ≥4) to 90-day treatment with ticagrelor or aspirin. Patients

2018 Stroke

74. Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial. (PubMed)

by conferring dual antiplatelet effect during a high-risk period for subsequent stroke. Therefore, we explored the efficacy and safety of ticagrelor versus aspirin in the patients who received any aspirin the week before randomization.A prespecified subgroup analysis in SOCRATES (n=13 199), randomizing patients with acute ischemic stroke (National Institutes of Health Stroke Scale score of ≤5) or transient ischemic attack (ABCD2 score of ≥4) to 90-day treatment with ticagrelor or aspirin. Patients

2018 Stroke

75. Report: Impact of drug combination of clopidogrel and pantoprazole In the prognosis of patients with transient ischemic attack. (PubMed)

% in the control group. The platelet aggregation before and after treatments between the two groups had not significant difference (P>0.05). The incidence of cerebrovascular events within 90 days (11.7% in the treatment group, 9.6% in the control group) between the two groups had not significant difference (P>0.05). Multivariate analysis showed that the incidence of cerebrovascular events within 90 day was associated with hypertension (P=0.008), diabetes (P=0.000), hyperlipidemia (P=0.002) and ABCD2 score >3

2017 Pakistan journal of pharmaceutical sciences

76. Factors Associated With Focal Computed Tomographic Perfusion Abnormalities in Supratentorial Transient Ischemic Attacks. (PubMed)

with FPA in patients with supratentorial TIAs.We prospectively collected consecutive patients with supratentorial TIAs defined by the traditional time-based definition who underwent CTP within 24 hours of symptom onset. We recorded demographics, risk factors, clinical features, severity, and timing from onset. We documented the Age, Blood Pressure, Clinical Features, Duration, and Diabetes (ABCD2) scores, vascular territories, and presence of relevant arterial pathology. Variables were tested

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2017 Stroke

77. When has service provision for transient ischaemic attack improved enough? A discrete event simulation economic modelling study. (PubMed)

and subsequent stroke.Included existing versus previous (less same day clinics) and hypothetical service reconfiguration (7-day service with less availability of clinics per day).The primary outcome of the model was the prevalence of major stroke after TIA. Secondary outcomes included service costs (including those of treating subsequent stroke) and time to treatment and attainment of national targets for service provision (proportion of high-risk patients (according to ABCD2 score) seen within 24 hours

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2017 BMJ open

78. Differences in Characteristics and Outcomes Between Asian and Non-Asian Patients in the (PubMed)

, 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

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2017 Stroke

79. MR perfusion lesions after TIA or minor stroke are associated with new infarction at 7 days. (PubMed)

), and underwent DWI/PWI at baseline and fluid-attenuated inversion recovery (FLAIR)/DWI 1 week after symptom onset were enrolled. Investigators blinded to clinical information independently assessed the presence of acute ischemic lesions on baseline DWI/PWI and follow-up DWI and FLAIR. Baseline and follow-up MRIs were then compared to determine the occurrence and location of new infarctions.Sixty-four patients met the inclusion criteria. Median (IQR) ABCD2 score was 4 (3-5). Median delay from onset

2017 Neurology

80. Coated-platelets predict stroke at 30 days following TIA. (PubMed)

Coated-platelets predict stroke at 30 days following TIA. To examine the potential for coated-platelets, a subset of highly procoagulant platelets observed on dual agonist stimulation with collagen and thrombin, for predicting stroke at 30 days in patients with TIA.Consecutive patients with TIA were enrolled and followed up prospectively. ABCD2 scores were obtained for each patient. Coated-platelet levels, reported as percent of cells converted to coated-platelets, were determined at baseline (...) value of 0.16 (95% CI 0.06-0.26), and negative predictive value of 0.98 (95% CI 0.96-1.0). The adjusted hazard ratio of incident stroke in patients with coated-platelet levels ≥51.1% was 10.72 compared to those with levels <51.1%. ROC analysis showed significant improvement in the predictive ability of the coated-platelet model compared to ABCD2 score (AUC 0.78 ± 0.07 vs 0.54 ± 0.07, p = 0.01).These findings suggest a role for coated-platelets in risk stratification for stroke at 30 days after TIA.©

2017 Neurology

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