Prospective study of vascular events and cerebral perfusional changes following transient ischemic attacks

A prospective case-control study was carried out to clarify associations of cerebral transient ischemic attacks (TIAs) and other stroke risk factors with progression and exacerbation of cardiovascular and cerebrovascular disorders; 243 neurologically normal controls and 123 TIA patients without prior history of stroke were followed up for a mean interval of 4.4 years. Of TIA patients, 26 (21%) developed other events (excluding recurrent TIAs); 10 died of vascular causes (8.1%). Of controls, 44 (18%) developed events; 13 died of vascular causes (5.4%) and 3 from cancer. TIA patients were at 2.3 times greater risk than normal controls for stroke or death from vascular causes. They were predominantly male with significantly higher associations of risk factors for stroke, including hypertension, heart disease, diabetes mellitus, smoking, hyperlipidemia, alcohol consumption, and limited education. Controls developing vascular events compared with controls who did not were older, more frequently male, and with greater incidences of heart disease. TIA patients had lower rates of cerebral perfusion compared with controls that persisted throughout the study, with similar rates of decline related to aging among both groups. Among TIA patients, stroke risk factors were more prevalent than among controls. The longer their duration, the greater the incidence and the more rapid the rate of severe, often fatal cardiovascular complications.