Evidence map›Paper›PMID 12700296›Full record

ArticleJournal of neurology, neurosurgery, and psychiatry2003

Long term risks of stroke, myocardial infarction, and vascular death in "low risk" patients with a non-recent transient ischaemic attack.

T G Clark, M F G Murphy, P M Rothwell

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, neurosurgery, and psychiatry, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00553241 (Phase 1 of Clinical Trial of Risk Factor, Prognosis, Imaging and Standard Management of Transient Ischemic Attack.), which is not on this map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00553241 unknown statusnot on this mapstarted 2007, after this paper: background citation

Phase 1 of Clinical Trial of Risk Factor, Prognosis, Imaging and Standard Management of Transient Ischemic Attack.

TypeobservationalSponsorCapital Medical UniversityRan2007 to 2009Enrolled1ConditionsIschemic Attack, Transient
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 143 citations in OpenAlex.

  1. Pooled it
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  3. Trial
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  6. Review
  7. Article
  8. Predictors of Adherence to Lifestyle Recommendations in Stroke Secondary Prevention.International journal of environmental research and public health · 2021
    Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Long-term morbidity and mortality in patients without early complications after stroke or transient ischemic attack.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017
    Article
  14. Review
  15. Article
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  18. Pathophysiology and Medical Treatment of Carotid Artery Stenosis.The International journal of angiology : official publication of the International College of Angiology, Inc · 2015
    Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

T G ClarkCentre for Statistics in Medicine, University of Oxford, Oxford, UK.
M F G Murphy
P M Rothwell
University of Oxford · GB

Funding

Medical Research Council G0500987
6 · The paper itself

Abstract

backgroundPrevious studies of prognosis after a transient ischaemic attack (TIA) have recruited patients soon after the event, when the risk of stroke is very high. However, the majority of patients survive for many years after a TIA, and the need for continued preventive treatment to lower vascular risk will need to be reassessed at a later date.

objectiveTo determine the long term risks of stroke and other vascular events in patients with TIA who survive the initial high risk period.

methods290 patients were studied who had initially been followed up after a TIA in the Oxford community stroke project and in a contemporaneous hospital based cohort study, and who were alive and stroke-free at the end of planned follow up in 1988. All patients were followed for a further 10 years, and the risks of major vascular events (stroke, myocardial infarction, vascular death) were determined. Standardised mortality ratios (SMR) were calculated from the observed numbers of fatal events and the number expected on the basis of age and sex in the general population.

resultsMedian time since last TIA was 3.8 years (interquartile range, 2.2 to 5.8 years). The risk of major vascular events was constant through time. The 10 year risk of first stroke was 18.8% (95% confidence interval (CI), 13.6 to 23.7; 45 events). The 10 year risk of myocardial infarction or death from coronary heart disease was 27.8% (95% CI, 21.8 to 33.3; 67 events) and there was a significant excess of fatal coronary events compared with that expected in the general population (SMR = 1.47; 95% CI, 1.10 to 1.93; p = 0.009). A total of 114 patients had at least one major vascular event, with a 10 year risk of any first stroke, myocardial infarction, or vascular death of 42.8% (95% CI, 36.4 to 48.5).

conclusionsThe overall risk of major vascular events remains high for 10 to 15 years after a TIA. It is important therefore that preventive treatments are continued in the long term, even in apparently "low risk" patients who have already survived free of stroke for several years.

Indexed as

AdultAgedAged, 80 and overCohort StudiesDisease-Free SurvivalFemaleFollow-Up StudiesHumansIschemic Attack, TransientMaleMiddle AgedMyocardial InfarctionOutcome Assessment, Health CarePrognosisRisk AssessmentStroke

Identifiers

PMID12700296
PMCPMC1738460
OpenAlexW2090665964

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.