Clinical Characteristics And Progonostic Analysis Of Atherosclerostic Transient Ischemic Attack

Atherosclerosis (AS) is main pathologic mechanism of ischemic stroke. AS causes TIA in two ways: one is hypoperfusion caused by stenosis,the other is caused by embolus from plaque rapture. In our previously retrospective analysis of 1003 TIA cases, we found that 41% TIA patients have stenosis, 56.2% have AS plaque, ABCD~2 score is related with AS plaque occurance rather than stenosis, and ABCD~2 score is higher when AS is more apparent. The results suggest us that with vessel examination results included in the ABCD~2 score, the accuracy of prediction scrore may be higher. To further understand retionship between AS and TIA and to choose a better method to predict high risk patients, we enroll the patients who were in hospitalized with the diagnosis of TIA in TIA clinical trial from April 2010 to December 2010 and analysis their clinical presentations, risk factors and outcomes of image and blood test and predict stroke risk with ABCD~3-V score, with the purpose of further investigating the relationship between transient ischemic attack and atherosiclerosis of the cerebral arteries and categorying the high risk patients with ABCD~3-V score. Results: (1) Patients with unstable plaque have different level high LDL-C. (2) 44.2% of TIA patients have middle cerebral artery stenosis and 50% of them are high grade stenosis. (3) Within those who developed to stroke, 75% have high grade cerebral artery stenosis, most of which located in middler cerebral artery. (4) Patiens with diabetes have higher risk to develope to the stroke. (5) 76.6% of patients have atherosiclerostic plaque and 16.9% of them have unstable plaque. (6) Among 31 patients who did MES, 16.1% has micro emboli. (7) ABCD~3-V score has high sensitivity and specificity when categorying the stroke risk patients, patients who have scores more than 7 have higher risk; ABCD~3-V does better than ABCD~3 or ABCD~2 when predicting high risk patients. (8) The TIA clinical trial has high variation.Conclusions: (1) High grade middle cerebral artery stenosis indicates high stroke risk within the TIA patients. (2) With microembolies indicate higher stroke risk (3) ABCD~3-V score can predict high stroke risk patient with high accuracy. (4) TIA clinical trail need more adjustment.