Prevalence and Outcomes of Cerebrovascular and Cardiovascular Events Among Transient Ischemic Attack Patients—a Cross-Sectional Study of National Estimate

Literature reported, 9–17% transient ischemic attack (TIA) patients have a vascular event within 90 days, but there is limited data on long-term risk involvement of vascular events following TIA. To identify prevalence and association of cardiovascular diseases (CVD) and cerebrovascular disorders (CeVD) among early and late transient ischemic attack (TIA) patients among US hospitalizations. We performed a retrospective cross-sectional analysis of Nationwide Inpatient Sample (2016–2017) in adults’ hospitalizations. Early TIA (primary diagnosis), late TIA (secondary diagnosis), and vascular events including CVD (atrial fibrillation (Afib), ischemic heart disease (IHD), angina, acute myocardial infarction (MI)) and CeVD (acute ischemic stroke (AIS), intracerebral hemorrhage (ICeH), and subarachnoid hemorrhage (SAH)) among TIA were identified using ICD 10 CM codes. Prevalence of vascular events was compared among patients with TIA and without TIA. Weighted analysis to account for sampling strategy using mixed-effect multivariable survey logistic regression was performed to evaluate odds of having vascular events among TIA in comparison with non-TIA. Among 71,473,874 US hospitalizations, 0.38% and 5.92% patients had early and late TIA, respectively. Patients with late TIA had a higher prevalence of acute MI (4.9 vs 0.5 vs 3.4%), IHD (44 vs 28.6 vs 20.6%), angina (0.3 vs 0.2 vs 0.2%), Afib (22 vs 15.3 vs 10.9%), AIS (5.3 vs 0.6 vs 2%), SAH (0.2 vs 0.03 vs 0.1%) and ICeH (0.8 vs 0.04 vs 0.4%) compared with early TIA and no-TIA, respectively (p < .0001). Patients with late TIA had 23% higher risk of having Afib (aOR 1.23; 95% CI 1.22–1.23) and higher odds of having IHD (1.52; 1.52–1.53), AIS (1.72; 1.70–1.74), and ICeH (1.29; 1.25–1.33). We found a higher prevalence and risk of vascular events in patients with late TIA among US hospitalizations. Hence, a thorough clinical investigation and long-term follow-up of TIA patients may mitigate the risk of future vascular events and associated health care burden.