Renowned neurologists at the University of Miami Miller School of Medicine have written an editorial published in the April 21 edition of the New England Journal of Medicine that strongly supports a multi-center stroke study, “One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke.”
The editorial, titled “The Value of Urgent Specialized Care for TIA and Minor Stroke,” was authored by Ralph L. Sacco, M.D., M.S., professor and Chairman of Neurology, and Olemberg Family Chair in Neurological Disorders, and Tatjana Rundek, M.D., Ph.D., professor of neurology and Vice Chair for Clinical Translational Research.
Conducted by an international team of neurologists, the Journal study examined the one-year risk of stroke in more than 3,000 patients who had experienced a transient ischemic attack (TIA) or minor stroke, in light of rapid treatment measures and urgent management in specialized units.
To better assess these approaches, the TIAregistry.org project was created to observe TIA or minor stroke patients one and five years out. In this one-year assessment, researchers report a 3.7 percent risk of stroke 90 days after a TIA or minor stroke (50 percent lower than previous studies), when evidence-based care was delivered by stroke specialists.
In their editorial, Sacco and Rundek support the use of urgent specialized care in treating patients with a TIA or minor stroke, writing that it “undoubtedly works” and these patients “have the least amount of disability and the most to lose should they have a stroke.”
The Miller School neurologists note the marked improvements in stroke prevention and evidence-based treatments that include anticoagulation therapy and interventional treatments, but point out that these techniques must be successfully implemented in hospital settings in order to affect patient outcomes.
“Just as the rapid diagnosis and treatment of acute stroke has improved outcomes, the urgent evaluation of patients with a TIA or minor stroke and the use of preventive treatments can markedly reduce the risk of stroke,” they said.
Sacco and Rundek point out limitations of the study: It did not compare whether specialized units performed better than non-specialized units, was not randomized and did not include any sites in the U.S. However, they did find the results support having more specialized units for TIA and minor stroke.
“This study should prompt health care providers and policymakers to make necessary changes in systems of stroke care in order to deliver the most effective care not only to patients with acute stroke, but also to those with a TIA or minor stroke,” they said.
Miller School Departments, Centers and Institutes
Neurologists Publish Editorial on Stroke Study in New England Journal of Medicine
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