Clinical Question: What is the like...

Clinical Question: What is the likelihood of serious nonstroke health issues following transient ischemic attacks or strokes?

Setting: Inpatient (any location) with outpatient follow-up

inquiry Design: Meta-analysis (other)

Synopsis: researchers searched the MEDLINE and Cochrane databases to identify English-language systematic reviews, randomized trials, and prospective cohort studies published after 1980 that monitored 100 or more patients for at least single year and accounted for at least 95 percent of the patients. They scanned the bibliographies of all the included studies still did not look for unpublished studies. brace members of the research team independently determined close attention eligibility and extracted the data. They resolv disagreements by the agency of discussion and consensus.

Based upon the 39 eligible studies with nearly 66000 patients, the yearly rates of nonstroke vascular death (21 percent) total myocardial infarctions (MI) (22 percent) fatal MI (11 percent) and nonfatal MI (09 percent) were fairly constant through time, but there was frequently variation in these rates in the different studies. Baseline characteristics of the inquiry participants did not seem to be the source of the heterogeneity.

Bottom Line: Following a affliction or transient ischemic attack, the annual rate of nonstroke vascular death and MI is approximately 2 percent by year. This information can be used to inform patients about the clinical course of their disease. (Level of Evidence: 1a)

HENRY BARRY, MD MS

meditation Reference: Touze E, et al. Risk of myocardial infarction and vascular death after transient ischemic attack and ischemic stroke: a systematic review and metaanalysis. rap December 2005;36:2748-55.

Used with permission from Barry H Annual rate of adverse nonstroke issues after TIA/stroke about 2%. Accessed online January 18 2006 at: http://www.InfoPOEMs.com.

COPYRIGHT 2006 American Academy of Family Physicians

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