Transient Ischemic Attack Outpatient Clinic: Past Journey and Future Adventure
Abstract
:1. Introduction
2. Models of Care for TIA Patients
3. Challenges of Outpatient TIA Management and Possible Solutions
3.1. Definition, Triage, and Diagnosis
3.2. System Dynamics of Outpatient TIA Clinics
3.3. Outcome Measures and Risk of Life-Threatening Complications
4. Tele-Stroke Centers
5. Ongoing Clinical Trials for Outpatient TIA Management
6. Future Direction
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study, Publication Year; Country | Recruitment | Study Design | Included Patients | Definition of mIS | Definition of TIA | Sample Size (N) | 2-Days Stroke Risk (%) | 7-Days Stroke Risk (%) | 30-Days Stroke Risk (%) | 90-Days Stroke Risk (%) | Mean Age (Year), Men (%) | Hypertension (%) | Diabetes (%) | Myocardial Infarction (%) | Ischemic Heart Disease (%) | Dyslipidemia (%) | Atrial Fibrillation (%) | Carotid Stenosis (%) | Smoking (%) | Prior TIA (%) | Prior Stroke (%) | ABCD2 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Chang et al. (RAVEN), [7] 2019; USA | 2016–2018 | R | TIA andmIS | - | Clsc | 101 | - | - | - | 0.9 | -, - | - | - | - | - | - | - | - | - | - | - | - |
Cheong et al., [13] 2019; Australia | 2012–2016 | P | TIA | NA | T. B. | 306 | 0.0 | 0.3 | 0.3 | 1.3 | 68, - | 58.0 | 18.0 | - | 12.0 | 48.0 | 10.0 | - | 17.0 | - | - | Median: 4 [3–5] |
Correia et al., [14] 2015; Portugal | 2004–2009 | P | TIA | NA | T. B. | 258 | - | - | 3.1 | 4.0 | 68, 59.7 | 73.5 | 17.1 | - | 9.7 | 47.3 | 8.9 | 76.7 | 67.7 | 8.5 | 2.3 | >4:72% |
Dutta et al., [15] 2016; UK | 2010–2012 | R | TIA and mIS | <24 h, Pos Imaging | Clsc | 529 | - | - | - | 1.3 | -, - | - | - | - | - | - | - | - | - | - | - | >4:31.5% |
Harrison et al. (Fast-Track TIA), [10] 2010; UK | 1992–2004 | R | TIA | NA | Clsc | 795 | - | - | - | 3.0 | 76, 43.0 | 29.2 | 8.2 | - | - | - | - | - | - | - | - | - |
Lavallée et al. (SOS-TIA), [16] 2017; France | 2003–2008 | P | TIA and mIS | >24 h | T. B. | 1850 | - | - | - | 3.6 | 63, 52.0 | 65.1 | 10.7 | 9.3 | 9.3 | 39.6 | 7.9 | 10.4 | 21.4 | 22.0 | 4.4 | >4:48.2% |
Majidi et al. (Stroke Bridge Clinic), [17] 2017; USA | 2013–2014 | R | TIA and mIS | NIHSS ≤ 3 | Clsc | 22 | - | 4.5 | - | - | -, - | - | - | - | - | - | - | - | - | - | - | - |
Montassier et al., [18] 2013; France | 2009–2009 | P | TIA | NA | T. B. | 62 | 1.7 | 1.7 | 1.7 | 1.7 | 73.1, 46.7 | 45.0 | 11.7 | - | 8.3 | 21.7 | 8.3 | - | 6.7 | 8.3 | 1.7 | >4:28.3% |
Olivot et al. (TWO ACES), [8] 2011; USA | 2007–2009 | P | TIA and mIS | ≥24 h | Clsc | 157 | - | 0.6 | 0.6 | 0.6 | 67, 55.0 | 49.0 | 11.0 | 3.0 | - | 51.0 | 16.0 | 0.7 | 6.0 | - | 15.0 | Median: 3 [3,4] |
Sanders et al. (M3T), [4] 2012; Australia | 2004–2007 | P | TIA | NA | Clsc | 301 | - | - | - | 2.4 | 67.7, 58.1 | 67.4 | 26.6 | - | - | 59.5 | 14.6 | 14.3 | - | - | - | - |
Vora et al. (TIA-TEAM), [19] 2015; USA | 2010–2011 | P | TIA | NA | Clsc | 58 | 0.0 | 1.7 | 1.7 | 1.7 | -, - | - | - | - | - | - | - | - | - | - | - | Median: 3 [2–4] |
Wasserman et al. (Ottawa), [20] 2010; Canada | 2007–2009 | P | TIA | NA | Clsc | 982 | 1.0 | 1.9 | 2.6 | 3.2 | 67, 50.9 | 58.1 | 19.9 | - | 16.6 | 32.5 | 8.6 | 45.0 | 13.3 | - | 11.7 | >4:67% |
Weitzel-Mudersbach et al., [21] 2011; Denmark | 2007–2008 | P | TIA | NA | Clsc | 107 | 0.9 | - | - | - | -, - | - | - | - | - | - | - | - | - | - | - | - |
Study and Outcome | Patient Stratification Strategy | Management | Clinic Details | Considerations |
---|---|---|---|---|
Chang et al. (RAVEN), [7] 2019; USA Outcome: RAVEN feasibility and safety; 90-day readmission or return to the ED; and risk of TIA, stroke, or death. | Clinic:
| ED:
|
|
|
Cheong et al., [13] 2019; Australia Outcome: 90-day stroke risk. | Stroke Unit:
| ED:
|
|
|
Correia et al., [14] 2015; PortugalOutcome: 30- and 90-day risk of stroke, TIA, MI, or vascular death among TIA versus possible TIA patients. |
| ED:
|
|
|
Dutta et al., [15] 2016; UK Outcome: 90-day, 1-year, 2-year, and end-of-follow-up risk of stroke, MI, any vascular event (TIA, stroke, or MI), and all-cause death. |
| Clinic:
|
|
|
Harrison et al. (Fast-Track TIA), [10] 2010; UK Outcome: Evaluate the prognostic value of ABCD and ABCD2 in subsequent stroke prediction up to 14 years. |
| Details are not available. |
|
|
Lavallée et al. (SOS-TIA), [16] 2017; France Outcome: 90-day and 1-year risk of stroke, MI, or vascular death; compare investigational findings between typical and atypical transient symptoms. | Clinic:
| Clinic: Based on a vascular neurologist’s opinion:
|
|
|
Majidi et al. (stroke bridge clinic), 2017; [17] USA Outcome: 7-day clinically detectable stroke, TIA, death, and clinical deterioration in the minor stroke subset. |
| ED:
|
|
|
Montassier et al., [18] 2013; France Outcome: 90-day TIA, stroke, death, and risk of stroke using ABCD2, symptomatic carotid stenosis > 70%, hospitalization for cardiovascular events. | Clinic:
| ED:
|
|
|
Olivot et al. (TWO ACES), [8] 2011; USA Outcome: 7-, 30-, and 90-day stroke, MI, and vascular death; program evaluation. |
| ED:
|
|
|
Sanders et al. (M3T), [4] 2012; Australia Outcome: 90-day stroke. |
| ED:
|
|
|
Vora et al. (TIA-TEAM), [19] 2015; USA Outcome: 7-, 90-, and 365-day risk of TIA, stroke, MI, or death, and compare with DWI and ABCD2 scores for stroke prediction rates. | Inpatient:
| ED:
|
|
|
Wasserman et al. (Ottawa), [20] 2010; Canada Outcome: 2-, 7-, 30-, and 90-day risk of stroke, TIA, MI, and death. | Inpatient:
| ED:
|
|
|
Weitzel-Mudersbach et al., [21] 2011; Denmark Outcome: 1-year combined risk of stroke, MI, or vascular death; 1-year secondary prevention compliance; 7- and 90-day and 1-year cumulated stroke risk. | Inside the primary coverage area:
| Stroke Unit: First outpatient visits or 24 h in the stroke unit:
|
|
|
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Shahjouei, S.; Seyedmirzaei, H.; Abedi, V.; Zand, R. Transient Ischemic Attack Outpatient Clinic: Past Journey and Future Adventure. J. Clin. Med. 2023, 12, 4511. https://doi.org/10.3390/jcm12134511
Shahjouei S, Seyedmirzaei H, Abedi V, Zand R. Transient Ischemic Attack Outpatient Clinic: Past Journey and Future Adventure. Journal of Clinical Medicine. 2023; 12(13):4511. https://doi.org/10.3390/jcm12134511
Chicago/Turabian StyleShahjouei, Shima, Homa Seyedmirzaei, Vida Abedi, and Ramin Zand. 2023. "Transient Ischemic Attack Outpatient Clinic: Past Journey and Future Adventure" Journal of Clinical Medicine 12, no. 13: 4511. https://doi.org/10.3390/jcm12134511
APA StyleShahjouei, S., Seyedmirzaei, H., Abedi, V., & Zand, R. (2023). Transient Ischemic Attack Outpatient Clinic: Past Journey and Future Adventure. Journal of Clinical Medicine, 12(13), 4511. https://doi.org/10.3390/jcm12134511