Early Treatment Reduces Risk of Recurrent Strokes

Rapid treatment following transient ischemic attack cuts risk of recurrent stroke by 80 percent

THURSDAY, Oct. 11 (HealthDay News) -- Early initiation of treatment after a minor stroke or transient ischemic attack (TIA) can dramatically reduce the 90-day risk of stroke, according to two studies published online Oct. 9 in The Lancet and The Lancet Neurology.

In the study in The Lancet, Peter M. Rothwell and colleagues from Radcliffe Infirmary in Oxford, United Kingdom, compared urgent assessment and immediate treatment in specialist clinics with subsequent treatment initiation in primary care clinics in 1,278 patients with TIA or minor stroke.

Of the 591 referrals to the study clinic, urgent assessment and treatment reduced the median delay to assessment from three days to less than one day, the median delay to first prescription of treatment from 20 days to one day, and the 90-day risk of recurrent stroke from 10.3 percent to 2.1 percent.

In the study in The Lancet Neurology, Philippa C. Lavallee, M.D., from Denis Diderot University and Medical School - Paris VII in France, and colleagues set up a hospital clinic with 24-hour access for patients with TIA and assessed patients within four hours of presentation.

Of 1,085 patients, 845 (78 percent) had confirmed or possible TIA and all started a stroke prevention program. The 90-day stroke rate was 1.24 percent compared with a predicted 5.96 percent based on ABCD2 scores. About three-quarters of all patients were sent home the same day.

"Patients with TIAs and minor strokes are not disabled. If the risk of a disabling stroke can be substantially reduced in this population, we strongly recommend that patients should receive the same urgent attention as is provided for those with acute coronary syndromes," according to the authors of an editorial in The Lancet.

Rothwell disclosed financial relationships with several pharmaceutical companies involved in manufacturing drugs used in secondary stroke prevention.

Abstract - Rothwell
Full Text (subscription or payment may be required)
Abstract - Lavallee
Full Text (subscription or payment may be required)

Physician's Briefing