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One year follow-up of patients clinically preselected for excessive risk of stroke
Insights
Identifying patients with excessive stroke risk (ESR) is possible using specific clinical criteria. This allows for targeted brain protection strategies, potentially avoiding large trials on unselected patients.
Area of Science:
- Neurology
- Vascular Neurology
- Cerebrovascular Disease
Background:
- Stroke remains a leading cause of disability and death.
- Identifying high-risk patients for preventative therapies is crucial.
- Current methods may include unselected patient populations in trials.
Purpose of the Study:
- To identify specific clinical criteria for selecting patients at excessive stroke risk (ESR).
- To evaluate the feasibility of subgrouping ESR patients for targeted interventions.
- To assess the incidence of cerebrovascular events in a high-risk cohort.
Main Methods:
- A cohort of 100 patients at high risk for stroke was selected from 812 patients.
- High-risk criteria included multiple transient ischemic attacks or severe carotid stenosis.
- Patients were divided into medical therapy (ischemic attacks) and surgical referral (stenosis) groups.
- Follow-up duration was 12 months.
Main Results:
- Out of 100 high-risk patients, 29 experienced cerebral ischemic events within 12 months.
- 17 patients suffered a stroke, and 12 experienced transient ischemic attacks (TIA).
- The study demonstrated the ability to identify subgroups within the ESR population.
Conclusions:
- Specific clinical criteria can identify patients with excessive stroke risk (ESR).
- Subgrouping ESR patients facilitates targeted brain protection strategies.
- This approach may optimize clinical trial selection and resource allocation.
Abstract:
From a consecutive series of 812 patients at risk of stroke we selected 100 who seemed to be at high risk (excessive stroke risk--ESR) on the following clinical criteria: either multiple reversible ischemic attacks in one carotid territory or multiple (or bilateral) severe stenotic carotid lesions. The patients of the first subgroup received medical therapy and those of the second were referred for surgery. The 100 patients were followed up for 12 months, during which 29 patients had cerebral ischemic events: 17 having stroke and 12 TIA. This study suggests that it is possible to identify beforehand subgroups of ESR patients, thereby facilitating the selection of patients for brain protection and avoiding huge trials of unselected cerebrovascular patients.