Epidemiological Impact in the United States of a Tissue-Based Definition of Transient Ischemic Attack

摘要: Background and Purpose— The traditional definition of transient ischemic attack (TIA), based on an arbitrary time criterion symptom resolution within 24 hours, is problematic because a large number patients with traditionally defined TIAs have relevant cerebral infarction brain imaging. objective this study was to characterize the epidemiological impact adopting tissue-based TIA. Methods— Estimates annual US incidence attacks were abstracted from literature. Models then constructed for determining frequency injury in TIAs, derived recent human studies MR diffusion-weighted imaging (DWI) ischemia. Results— Traditionally TIA rates ranged 37 107 per 100 000 year. Across 5 series, raw DWI positivity 44%. Adjusting overrepresentation longer-duration series yielded expected diffusion MRI 33% unselected, TIAs. Applying model population year 2000 showed that would decrease events classified as 179 840 120 493 increase strokes 821 181 880 520. Conclusions— Adopting reduce estimates by (sensitivity analysis range, 19% 44%) stroke United States 7% (range, 4% 10%).