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Riesgo a largo plazo de accidente cerebrovascular después de un ataque isquémico transitorio o un accidente
, Faizan Khan1, Vignan Yogendrakumar2,3
1Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
JAMA
|March 26, 2025
Resumen
Los pacientes que experimentan un ataque isquémico transitorio (AIT) o un accidente cerebrovascular leve se enfrentan a un riesgo significativo a largo plazo de recidiva del accidente cerebrovascular. Este estudio pone de relieve la necesidad urgente de mejorar las estrategias de prevención de accidentes cerebrovasculares para estas personas.
Área de la Ciencia:
- Neurología
- Epidemiología
- Salud pública
Sus antecedentes:
- El riesgo a largo plazo de accidente cerebrovascular después de un ataque isquémico transitorio (AIT) o un accidente cerebrovascular leve no está bien establecido.
- La comprensión de este riesgo es crucial para las estrategias eficaces de prevención secundaria.
Objetivo del estudio:
- Determinar la incidencia anual y las tasas acumuladas de accidente cerebrovascular hasta 10 años después del AIT o accidente cerebrovascular leve.
- Identificar los factores que influyen en el riesgo de ictus en esta población de pacientes.
Principales métodos:
- Una revisión sistemática y un metanálisis de los estudios de cohorte prospectivos y retrospectivos.
- Inclusión de estudios con un seguimiento mínimo de 1 año en pacientes con AIT o ACV leve.
- Análisis combinado de datos a nivel agregado de 38 estudios en los que participaron 171.068 pacientes.
Principales resultados:
- La incidencia acumulada del accidente cerebrovascular fue de 5,94 por cada 100 años-persona en el primer año, disminuyendo a 1,80 y 1,72 por año en los períodos posteriores.
- La incidencia acumulada de ictus alcanzó el 12, 5% a los 5 años y el 19, 8% a los 10 años.
- Se observaron tasas más altas de accidentes cerebrovasculares en América del Norte y Asia, en cohortes recientes, y con una verificación activa del resultado.
Conclusiones:
- Los pacientes con antecedentes de AIT o accidente cerebrovascular leve tienen un riesgo persistentemente alto de accidente cerebrovascular posterior.
- Los hallazgos subrayan la necesidad crítica de medidas de prevención mejoradas y sostenidas a largo plazo para este grupo vulnerable.
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