JAMA

Long-term stroke risk remains high after TIA or minor stroke

March 31, 2025

Study details: The aim of this systematic review and meta-analysis including 38 studies with 171,068 patients was to determine the long-term risk of stroke following a transient ischemic attack (TIA) or minor stroke. The analysis pooled data from studies with a minimum follow-up of one year, using random-effects meta-analysis to calculate incidence rates.

Results: The pooled stroke rate was 5.94 per 100 person-years in the first year, 1.80 annually in years two through five, and 1.72 annually in years six through ten. Within the first year, 61.7% of repeat strokes occurred in the first 90 days, highlighting the high initial risk. The cumulative incidence of stroke was 12.5% at five years and 19.8% at ten years. Stroke rates were higher in North America and Asia compared to Europe, and in cohorts recruited after 2007. Studies focusing solely on TIA patients or first-ever index events reported lower stroke rates.

Clinical impact: High risk of stroke in patients with TIA or minor stroke persists for years, highlighting the need for robust long-term secondary prevention strategies. Clinicians should be vigilant in managing risk factors and ensuring adherence to preventive measures to mitigate this risk.

Source:

Writing Committee for the PERSIST Collaborators; Khan F, et al. (2025, March 26). JAMA. Long-Term Risk of Stroke After Transient Ischemic Attack or Minor Stroke: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/40136306/