Stroke, TIA Survivors Without Early Complications Still Face Increased Long-Term Risks

By Amy Orciari Herman

Edited by Susan Sadoughi, MD

Adults who are clinically stable in the early period after a stroke or transient ischemic attack face increased risks for adverse outcomes years later, according to a Canadian Medical Association Journal study.

Using Ontario health registries, researchers identified over 26,000 patients who experienced an ischemic stroke or TIA and did not have major complications within 90 days after discharge. These cases were matched to 260,000 controls without stroke or TIA.

At 1 year, the primary composite outcome — death, recurrent stroke, MI, or admission to a care facility — was more common among cases than controls (10% vs. 5%). Elevated risk among cases was maintained at 3 years (24% vs. 14%) and 5 years (36% vs. 21%). Although stroke survivors had the greatest risks, nearly a third of TIA survivors experienced adverse events.

The researchers conclude, "These analyses indicate that survival after both stroke and TIA is a marker of major long-term risk, which merits aggressive attention to risk reduction strategies."