Ois Santiago, Angel JavierCuadrado-Godia, ElisaGiralt-Steinhauer, EvaJiménez Conde, JordiSoriano Tarraga, CarolinaRodríguez-Campello, AnaAvellaneda Gómez, CarlaCascales Lahoz, DiegoFernández-Pérez, IsabelRoquer, Jaume2020-02-182020-02-182019Ois A, Cuadrado-Godia E, Giralt-Steinhauer E, Jimenez-Conde J, Soriano-Tarraga C, Rodríguez-Campello A et al. Long-term stroke recurrence after transient ischemic attack: implications of etiology. J Stroke. 2019 May;21(2):184-9. DOI: 10.5853/jos.2018.036012287-6391http://hdl.handle.net/10230/43622Background and purpose: To analyze long-term stroke recurrence (SR) characteristics after transient ischemic attack (TIA) according to initial etiological classification. Methods: A prospective cohort of 706 TIA patients was followed up in a single tertiary stroke center. Endpoint was SR. Etiologic subgroup was determined according to the evidence-based causative classification system. Location of TIA and SR was recorded as right, left, or posterior territory. Disability stroke recurrence (DSR) was defined as modified Rankin Scale (mRS) score >1 or a onepoint increase in those with previous mRS >1 at 3-month follow-up. Results: During a follow-up of 3,493 patient-years (mean follow-up of 58.9±35.9 months), total SR was 125 (17.7%), corresponding to 3.6 recurrences per 100 patient-years. The etiology subgroups with a higher risk of SR were the unclassified (more than one cause) and large-artery atherosclerosis (LAA) categories. Of the SR cases, 88 (70.4%) had the same etiology as the index TIA; again, LAA etiology was the most frequent (83.9%). Notably, cardioaortic embolism was the most frequent cause (62.5%) of SR in the subgroup of 24 patients with undetermined TIA. Overall, SR occurred in the same territory in 74 of 125 patients (59.2%), with significant differences between etiological TIA subgroups (P=0.015). Eighty-two of 125 (65.6%) with SR had DSR, without differences between etiologies (P=0.453). Conclusions: SR occurred mainly with the same etiology and location as initial TIA, although undetermined TIA was associated with a high proportion of cardioaortic embolism SR. More than half of the recurrences caused some disability, regardless of etiology.application/pdfengCopyright © 2019 Korean Stroke Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/articlehttp://dx.doi.org/10.5853/jos.2018.03601Ischemic attackTransientRecurrenceStrokeinfo:eu-repo/semantics/openAccess