22. European Stroke Conference 725 Acute cerebrovascular events (ACE): TIA and minor strokes Blood Biomarkers and Recurrence of Stroke in Patients with Transient Ischemic Attack – A Systematic Review F. Carioca1, P. Canhão2 Hospital de Santa Maria, University of Lisbon, Lisbon, PORTUGAL1, Hospital de Santa Maria, University of Lisbon, Lisbon, PORTUGAL2 Background– Several predictors have been proposed to identify the risk of stroke recurrence in pa-tients with Transient Ischemic Attack (TIA). Apart from clinical and imaging predictors, blood bio-markers have been suggested for this purpose. The main goal of this study is to carry out a systemat-ic review of the literature to find all biomarkers evaluated as prognostic predictors in TIA cohorts. Methods – We searched PubMed (1974 to June 2012) aiming to find studies measuring blood bio-markers in TIA patients (<72h) and assessing their association with stroke recurrence. We planned to perform a meta-analysis providing that blood concentrations were given. Results –The electronic search yielded 827 studies, 53 were selected for full reading, and seven studies met the inclusion criteria. The studies were heterogeneous and generally small (mean 147 patients, ranging between 94 and 194). The effect of blood biomarkers was adjusted for other out-come predictors in six studies (ABCD2 score, age and carotid disease). The following biomarkers were assessed: C-reactive protein (CRP) (three studies), Lp-PLA2 mass and activity (two), D-dimers (one), Copeptin (one), Cortisol (one) and Troponin I (one). Copeptin and Lp-PLA2 mass and activ-ity were associated with recurrence of stroke 90 days after TIA. The association between the CRP and stroke recurrence could not be established, given the opposite results of the studies. D-dimer and Cortisol were not associated with stroke recurrence in TIA patients. Conclusion – Blood biomarkers as Lp-PLA2 mass and activity, Copeptin and CRP were targeted as possible predictors of stroke recurrence in TIA, but more studies are required to confirm their use-fulness. Investigators should attempt to standardize studies’ design and enlarge the sample size in order to import their results to clinical practice. 728 © 2013 S. Karger AG, Basel Scientific Programme 726 Acute cerebrovascular events (ACE): TIA and minor strokes Difference of Knowledge and Secondary Prevention Compliance of Stroke between Transient Ischemic Attack Patients with and without Subsequent Stroke J.J. Zhao1, M.K. Zhou2, J. Guo3, L. He4 Department of neurology, west china hospital of Sichuan university, Chengdu, CHINA1, De-partment of neurology, west china hospital of Sichuan university, Chengdu, CHINA2, Department of neurology, west china hospital of Sichuan university, Chengdu, CHINA3, Department of neurology, west china hospital of Sichuan university, Chengdu, CHINA4 Background: Latest guidelines from the National Stroke Association (NSA), The European Stroke Organization (ESO) and China recommend that Transient Ischemic Attack (TIA) patients should re-ceive early secondary prevention. Lack of knowledge about stroke may lead to poor compliance of secondary prevention of stroke in patients with TIA. We set out to evaluate the difference of knowl-edge and secondary prevention compliance of stroke between TIA patients with and without subse-quent stroke. Methods: We consecutively enrolled TIA patients with/without subsequent stroke from our hospi-tal from December 1, 2008, to December 31, 2011. All enrolled patients received health education both at hospital discharge and 90 days after discharge. The survey was designed to record detailed information including telephone interview of patients’ general knowledge of stroke 6 months after discharge (such as the warning signs and the risk factors of stroke) and secondary prevention com-pliance of stroke (such as the adherence to evidence-based medicine and related lifestyle modifica-tions). Results: TIA patients with subsequent stroke have a higher identification rate of warning signs of stroke such as speech disorder, weakness, decreased sensation or inability to feeling things than those without subsequent stroke (76.1% vs 66.3%, P=0.001; 91.5% vs 73.5%, P=0.002; 62.2% vs 46.9%, P=0.041). There were no differences of risk factors of stroke between the two groups. And, hypertension was the most frequently identified risk factor. The adherence rate of anti-platelet agent and statins therapy were higher in TIA patients with subsequent stroke than those without it (80.5% vs 65.3%, P=0.024; 53.7% vs 35.7%, P=0.016). There were no differences in antihypertensive, hy-poglycemic therapy, and lifestyle modifications between the two groups. Conclusion: TIA patients with subsequent stroke have higher identification rate of warning signs of stroke, better adherence of secondary prevention of stroke than those without subsequent stroke. To attain a better compliance of secondary prevention of stroke, TIA patients deserve more health edu-cation to make them aware the harms of subsequent stroke.
Karger_ESC London_2013
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