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NEUROLOGY 1989;39:982
© 1989 American Academy of Neurology

Changes in survival after transient ischemic attacks

Observations comparing the 1970s and 1980s

G. Howard, DrPH, J. K. Brockschmidt, MS, L. A. Rose, BA, J. L. Frye-Pierson, BSN, J. R. Crouse, MD, G. W. Evans, MA, E. S. Mitchell, MS and J. F. Toole, MD

Stroke Research Center, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC (Drs. Howard, Grouse, and Toole, Ms. Rose, Ms. Frye-Pierson, and Mr. Evans)
Center for Prevention Research and Biometry, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC (Dr. Howard, Ms. Brockschmidt, and Mr. Evans)
Atherosclerosis Research Center, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC (Dr. Crouse and Ms. Mitchell)

We compared survival following transient ischemic attack (TIA) in 2 prospective cohorts of TIA patients admitted to Wake Forest University Medical Center. The 1st consisted of 177 patients admitted between 1961 and 1973, and the 2nd of 185 patients admitted between 1980 and 1983. Patients in the 2nd cohort had significantly greater longevity than patients in the 1st cohort, both univariately and after adjustment for cerebrovascular risk factors. The adjusted 1-year survival estimate increased from 91% in the 1st cohort to 98% in the 2nd, and the adjusted 3-year survival estimate increased from 83% in the 1st to 94% in the 2nd. The underlying causes for this dramatic improvement in survival may include early identification and aggressive management of TIAs or coexisting diseases, improved management of subsequent completed strokes or myocardial infarctions, or unadjusted differences in these cohorts. The data imply that reports of TIA survival from different periods may not be comparable.

Address correspondence and reprint requests to Dr. Howard, Center for Prevention Research and Biometry, Bowman Gray School of Medicine, 300 South Hawthorne Road, Winston-Salem, NC 27103.

Supported in part by Public Health Service grant NINCDS-NS06655, and by the Specialized Center of Research in Arteriosclerosis grant HL-14164, and Preventive Cardiology Academic Award HL-01472 to J.R.C.

Received November 16,1988. Accepted for publication in final form January 17, 1989.






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