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Minor Strokes May Lead to Major Ones

Study: Stroke or Heart Attack Often Follow Within 10 Years
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WebMD Health News

June 16, 2005 -- Dutch researchers say minor strokes, or transient ischemic attacks (TIAs), are often followed by other strokes or heart attacks within the next decade.

That's all the more reason to improve prevention efforts in TIA survivors, say the researchers, who included Ale Agra, MD, of the neurology department at the University Medical Centre Utrecht in the Netherlands.

Agra's team studied more than 2,400 TIA patients for 10 years. They found that 60% of the patients had died and 54% had a least one heart attack or stroke.

They show that during a 10-year period, a person with a history of a minor stroke has a 44% risk of having a stroke or heart attack. The results appear in The Lancet.

They also show that less than half (48%) survived 10 years without having a stroke or a heart attack.

When Stroke Strikes

Every 45 seconds, someone in the U.S. has a stroke. Every three minutes, someone dies of a stroke. That's about 700,000 strokes and nearly 163,000 deaths per year, says the American Stroke Association.

Stroke is the No. 3 cause of U.S. deaths. If not fatal, stroke can be disabling. Immediate medical attention is a must, since some stroke medications have to be given in a short time frame.

Warning signs listed by the American Stroke Association include:

  • Sudden numbness or weakness of the face, arms, or leg, especially on one side of the body
  • Sudden confusion or trouble with speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden dizziness, loss of balance or coordination, or trouble walking
  • Sudden, severe headache with no known cause

Stroke can happen when a blood clot blocks blood flow to the brain (ischemic -- the most common type) or when a blood vessel bursts (hemorrhagic) and prevents blood from reaching the brain.

TIA Study

In TIAs, clots are temporary and the symptoms often go away quickly. But make no mistake; they are not innocent events and deserve swift care. The symptoms are the same as those of a stroke, but are temporary.

TIAs can precede bigger strokes and other problems, as Agra and colleagues found.

On average, Agra's participants were 65 years old. They signed up for the study within three months of their TIA or minor stroke. It's not known if that was their first such event.

"Our study shows that, roughly 10 years after a presentation of TIA or minor ischemic stroke, about 60% of patients had died and 54% had experienced at least one new vascular event," says the study. "Event-free survival after 10 years was 48%."

Risk's Patterns

The risk of stroke is highest immediately following the first event. However, in the study it declined during the first three years and then gradually rose again.

Death risk was higher for older participants, as well as those with diabetes, a history of a heart attack, and past surgery for poor circulation.

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