{"id":28121,"date":"2025-05-29T04:56:00","date_gmt":"2025-05-28T20:56:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28121"},"modified":"2025-05-29T05:57:14","modified_gmt":"2025-05-28T21:57:14","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%b8%80%e8%bf%87%e6%80%a7%e8%84%91%e7%bc%ba%e8%a1%80%e5%8f%91%e4%bd%9c%e6%88%96%e5%b0%8f%e5%8d%92%e4%b8%ad%e5%90%8e%e5%8f%91%e7%94%9f%e5%8d%92","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28121","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u4e00\u8fc7\u6027\u8111\u7f3a\u8840\u53d1\u4f5c\u6216\u5c0f\u5352\u4e2d\u540e\u53d1\u751f\u5352\u4e2d\u7684\u957f\u671f\u98ce\u9669"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

March 26, 2025<\/p>\n\n\n\n

Long-Term Risk of Stroke After Transient Ischemic Attack or Minor Stroke: A Systematic Review and Meta-Analysis<\/h1>\n\n\n\n

Writing Committee for the PERSIST Collaborators<\/h3>\n\n\n\n

JAMA. <\/em>Published online March 26, 2025. doi:10.1001\/jama.2025.2033<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the long-term risk of stroke after transient ischemic attack (TIA) or minor stroke?<\/p>\n\n\n\n

Findings<\/strong>  In this systematic review and meta-analysis of 171\u202f068 patients with TIA or minor stroke from 38 studies, the risk of subsequent stroke was 5.9% within 1 year, 12.8% within 5 years, and 19.8% within 10 years.<\/p>\n\n\n\n

Meaning<\/strong>  Patients who have had a TIA or minor stroke are at a persistently high risk of subsequent stroke. There is a need for continued improvement in long-term stroke prevention.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  After a transient ischemic attack (TIA) or minor stroke, the long-term risk of stroke is not well-known.<\/p>\n\n\n\n

Objective<\/strong>  To determine the annual incidence rates and cumulative incidences of stroke up to 10 years after TIA or minor stroke.<\/p>\n\n\n\n

Data Sources<\/strong>  MEDLINE, Embase, and Web of Science were searched from inception through June 26, 2024.<\/p>\n\n\n\n

Study Selection<\/strong>  Prospective or retrospective cohort studies reporting stroke risk during a minimum follow-up of 1 year in patients with TIA or minor stroke.<\/p>\n\n\n\n

Data Extraction and Synthesis<\/strong>  Two reviewers independently performed data extraction and assessed study quality. Unpublished aggregate-level data on number of events and person-years during discrete follow-up intervals were obtained directly from the authors of the included studies to calculate incidence rates in individual studies. Data across studies were pooled using random-effects meta-analysis.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was any stroke. Study-level characteristics were investigated as potential sources of variability in stroke rates across studies.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0The analysis involved 171\u202f068 patients (median age, 69 years [IQR, 65-71]; median proportion of male patients, 57% [IQR, 52%-60%]) from 38 included studies. The pooled rate of stroke per 100 person-years was 5.94 events (95% CI, 5.18-6.76; 38 studies;\u00a0I<\/em>2<\/sup>\u2009=\u200997%) in the first year, 1.80 events (95% CI, 1.58-2.04; 25 studies;\u00a0I<\/em>2<\/sup>\u2009=\u200990%) annually in the second through fifth years, and 1.72 events (95% CI, 1.31-2.18; 12 studies;\u00a0I<\/em>2<\/sup>\u2009=\u200984%) annually in the sixth through tenth years. The 5- and 10-year cumulative incidence of stroke was 12.5% (95% CI, 11.0%-14.1%) and 19.8% (95% CI, 16.7%-23.1%), respectively. Stroke rates were higher in studies conducted in North America (rate ratio [RR], 1.43 [95% CI, 1.36-1.50]) and Asia (RR, 1.62 [95% CI, 1.52-1.73]), compared with Europe, in cohorts recruited in or after 2007 (RR, 1.42 [95% CI, 1.23-1.64]), and in studies that used active vs passive outcome ascertainment methods (RR, 1.11 [95% CI, 1.07-1.17]). Studies focusing solely on patients with TIA (RR, 0.68 [95% CI, 0.65-0.71) or first-ever index events (RR, 0.45 [95% CI, 0.42-0.49]) had lower stroke rates than studies with an unselected patient population.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Patients who have had a TIA or minor stroke are at a persistently high risk of subsequent stroke. Findings from this study underscore the need for improving long-term stroke prevention measures in this patient group.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  March 26, 2025 L […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28121"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28121"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28121\/revisions"}],"predecessor-version":[{"id":28499,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28121\/revisions\/28499"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28121"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28121"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28121"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}