ホシノ　タカオ   Hoshino Takao   星野　岳郎    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Five-Year Prognosis After TIA or Minor Ischemic Stroke in Asian and Non-Asian Populations.
掲載誌名	正式名：Neurology 略　 称：Neurology ISSNコード：1526632X/00283878
掲載区分	国外
巻・号・頁	96(1),pp.e54-e66
著者・共著者	Hoshino Takao†, Uchiyama Shinichiro, Wong Lawrence K S, Kitagawa Kazuo, Charles Hugo, Labreuche Julien, Lavallée Philippa C, Albers Gregory W, Caplan Louis R, Donnan Geoffrey A, Ferro José M, Hennerici Michael G, Molina Carlos, Rothwell Peter M, Steg P Gabriel, Touboul Pierre-Jean, Vicaut Éric, Amarenco Pierre*
発行年月	2021/01
概要	OBJECTIVE:To determine long-term vascular outcomes of Asian patients who experienced TIA or minor ischemic stroke and to compare the outcomes of Asian patients with those of non-Asian patients, in the context of modern guideline-based prevention strategies.METHODS:This is a subanalysis of the TIAregistry.org project, in which 3,847 patients (882 from Asian and 2,965 from non-Asian countries) with a recent TIA or minor ischemic stroke were assessed and treated by specialists at 42 dedicated units from 14 countries and followed for 5 years. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome.RESULTS:No differences were observed in the 5-year risk of the primary outcome (14.0% vs 11.7%; hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.88-1.37; p = 0.41) and stroke (10.7% vs 8.5%; HR, 1.17; 95% CI, 0.90-1.51; p = 0.24) between Asian and non-Asian patients. Asian participants were at higher risk of intracranial hemorrhage (1.8% vs 0.8%; HR, 2.23; 95% CI, 1.09-4.57; p = 0.029). Multivariable analysis showed that the presence of multiple acute infarctions on initial brain imaging was an independent predictor of primary outcome and modified Rankin Scale score of >1 in both Asian (HR, 1.91; 95% CI, 1.11-3.29; p = 0.020) and non-Asian (HR, 1.39; 95% CI, 1.02-1.90; p = 0.037) patients.CONCLUSION:The long-term risk of vascular events in Asian patients was as low as that in non-Asian patients, while Asian participants had a 2.2-fold higher intracranial hemorrhage risk. Multiple acute infarctions were independently associated with future disability in both groups.CLASSIFICATION OF EVIDENCE:This study provides Class I evidence that among people who experienced TIA or minor stroke, Asian patients have a similar 5-year risk of cardiovascular death, stroke, and acute coronary syndrome as non-Asian patients.
DOI	10.1212/WNL.0000000000010995
PMID	33046613