The analysis of risk factors and clinical features of patients with transient ischemic attacks in posterior circulation

doi:10.3877/cma.j.issn.2095-8757.2015.01.009

Abstract

Abstract:

Objective

To analyze the clinical features, risk factors and prognosis of patients with transient ischemic attacks (TIA) in posterior circulation, and provide the evidence for prevention of stroke.

Methods

We prospectively selected 88 posterior circulation TIA patients from October 2010 to December 2013, analyzed their clinical features, risk factors (hypertension, diabetes, hyperlipoidemia, coronary artery disease, atrial fibrillation and smoke).

Results

69.3% patients were older than 60 years. The most common feature of posterior circulation TIA patients were dizziness (44.3%) and the duration of symptoms was less than ten minutes (43.2%). The incidence of hypertension was highest (48.9%) among these risk factors. 20.5% patients had vertebrobasilar arterial stenosis≥50%. And 8% (7/88) patients suffered stroke in 7 days after TIA. The Logistic regression analysis of 6 risk factors (hypertension, diabetes, hyperlipoidemia, coronary artery disease, atrial fibrillation and smoke) showed that diabetes was the independent risk factor of the stroke after posterior circulation of TIA (OR=5.867, 95%CI: 1.186-29.014,P<0.05).

Conclusion

The clinical features of patients with transient ischemic attacks (TIA) in posterior circulation were complex. Hypertension was the most common risk factor and diabetes may affect more on stroke after TIA.

Key words: Cerebrovascular circulation, Ischemic attacks, Transient, Risk factor, Stroke

Junjun Wang, Yaguo Li, Xiaoli Liu. The analysis of risk factors and clinical features of patients with transient ischemic attacks in posterior circulation[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2015, 02(01): 32-34.

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References 16

[1]	Rothwell PM, Warlow CP.Timing of TIAs preceding stroke: time window for prevention is very short[J].Neurology, 2005, 64(5): 817-820.
[2]	Meng X, Wang Y, Liu L, et al. Validation of the ABCD(2)-I score to predict stroke risk after transient ischemic attack[J]. Neurol Res, 2011, 33(5): 482-486.
[3]	Rothwell PM, Giles MF, Chandrathera A, et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke(EXPRESS study): a prospective population-based sequential comparison[J]. Lancet, 2007, 370(9596): 1432-142.
[4]	Flossmann E, Rothwell PM. Prognosis of vertebrobasilar transient ischaemic attack and minor stroke[J]. Brain, 2003, 126(pt9): 1940-1954.
[5]	Smajlovic D, Ibrahimagic O, Dostovic Z. Ischemic insult in the anterior and posterior cerebral circulation[J].Med Arh, 2003, 57(4): 227-229.
[6]	中华神经科学会．各类脑血管疾病诊断要点[J]．中华神经科杂志，1996，29(6): 379-380.
[7]	Disorders. A classification and outline of cerebrovascular diseasesⅡ[J]. Stroke, 1975, 6(5): 564-616.
[8]	European Stroke Organisation (ESO) Executive Committee,ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008[J]. Cerebrovasc Dis, 2008, 25(5): 457-507.
[9]	Easton JD,Saver JL,Albers GW, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists[J]. Stroke, 2009, 40(6): 2276-2293.
[10]	Searls DE,Pazdera L,Korbel E, et al. Symptoms and signs of posterior circulation ischemia in the new England medical center posterior circulation registry[J]. Arch Neurol, 2012, 69(3): 346-351.
[11]	Cucchiara BL,Messe SR,Sansing L, et al. D-dimer,magnetic resonance imaging diffusion-weighted imaging, and ABCD2 score for transient ischemic attack risk stratification[J]. J Stroke Cerebrovasc Dis, 2009, 18(5): 367-373.
[12]	Ay H,Arsava EM,Johnston SC, et al. Clinical-and imaging-based prediction of stroke risk after transient ischemic attack: the CIP model[J]. Strok, 2009, 40(1): 81-86.
[13]	Moreno-Rojas AJ,González-Marcos JR,Gil-Peralta A, et al. Vascular risk factors in patients with infratentorial vertebrobasilar ischemia[J]. Rev Neurol, 1998, 26(149): 113-117.
[14]	Giles MF, Rothwell PM. Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis[J]. Lancet Neurol, 2007, 6(12): 1063-1072.
[15]	Johnston SC,Rothwell PM,Nguyen-Huynh MN, et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack[J]. The Lancet, 2007, 369(9558): 283-292.
[16]	Subramanian G,Silva J,Silver FL, et al. Risk factors for posterior compared to anterior ischemic stroke: an observational study of the Registry of the Canadian Stroke Network[J].Neuroepidemiology, 2009, 33(1): 12-16.

临床特征		例（%）
年龄		?
?	≥60岁	61（69.3）
临床表现		?
?	头晕	39（44.3）
?	感觉障碍	18（20.5）
?	言语含糊	17（19.3）
?	眩晕	10（11.4）
?	视物模糊或视野缺损	13（14.8）
?	共济失调	8（9.1）
?	全面性遗忘	2（2.3）
?	猝倒	1（1.2）
症状持续时间（min）		?
?	<10	38（43.2）
?	10~59	31（35.2）
?	≥60	19（21.6）
危险因素		?
?	高血压	43（48.9）
?	高脂血症	33（37.5）
?	吸烟	22（25.0）
?	糖尿病	19（21.6）
?	冠心病	17（19.3）
?	房颤	12（13.6）
椎基底动脉狭窄≥50%		18（20.5）
7 d内发生脑卒中		7（8.0）

临床特征		例（%）
年龄		?
?	≥60岁	61（69.3）
临床表现		?
?	头晕	39（44.3）
?	感觉障碍	18（20.5）
?	言语含糊	17（19.3）
?	眩晕	10（11.4）
?	视物模糊或视野缺损	13（14.8）
?	共济失调	8（9.1）
?	全面性遗忘	2（2.3）
?	猝倒	1（1.2）
症状持续时间（min）		?
?	<10	38（43.2）
?	10~59	31（35.2）
?	≥60	19（21.6）
危险因素		?
?	高血压	43（48.9）
?	高脂血症	33（37.5）
?	吸烟	22（25.0）
?	糖尿病	19（21.6）
?	冠心病	17（19.3）
?	房颤	12（13.6）
椎基底动脉狭窄≥50%		18（20.5）
7 d内发生脑卒中		7（8.0）

危险因素	OR值	95%CI	P值
高血压	2.829	0.518～15.437	0.230
糖尿病	5.867	1.186～29.014	0.030
高脂血症	0.255	0.029～2.220	0.216
冠心病	3.589	0.722～17.848	0.118
房颤	2.840	0.485～16.647	0.247
吸烟	1.220	0.219～6.785	0.820

危险因素	OR值	95%CI	P值
高血压	2.829	0.518～15.437	0.230
糖尿病	5.867	1.186～29.014	0.030
高脂血症	0.255	0.029～2.220	0.216
冠心病	3.589	0.722～17.848	0.118
房颤	2.840	0.485～16.647	0.247
吸烟	1.220	0.219～6.785	0.820

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