London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 731 732 Acute cerebrovascular events (ACE): TIA and minor strokes Blacks are Less Likely to be Admitted with Transient Ischemic Attack than Whites in the Bronx, NY D. Bhupali1, D.L. Labovitz2 Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA1, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA2 Background: Because the mechanism for transient ischemic attack (TIA) is the same as for ischemic stroke (IS), with only the duration of vascular occlusion and availability of collateral blood flow sep-arating them, the TIA-IS ratio, defined as the ratio of TIA to IS cases, theoretically should be identi-cal across demographic strata. Our objective was to assess whether the TIA-IS ratio varies by race, sex or age among white, black and Hispanic residents of the Bronx. Methods: TIA and IS cases were identified from the Montefiore Stroke Registry from January 2009- June 2011 using primary ICD9 discharge codes and confirmed by chart review. Chi-square and Stu-dent’s t-test were used for univariate and logistic regression for multivariate comparisons. Results: There were 416 TIA and 1762 IS cases confirmed by chart review among white, black and Hispanic patients. Older age (p<0.0001) and male sex (p<0.0001) were associated with lower TIA-IS ratios. Whites (mean age 78 years) were older than blacks (67 years, p<0.0001) and Hispanics (68 years, p<0.0001). In a multivariate model adjusted for hospital site, male sex (TIA-IS OR=0.57, 95% CI 0.45-0.71), older age (0.98, 0.97-0.99) and black race (0.69, 0.55-0.87) were associated with lower TIA-IS ratios. Conclusion: The TIA-IS ratio differs by age, sex and race, with patients who are of older age, male, or black less likely to receive the diagnosis of TIA. In the US, many hospitals routinely admit pa-tients diagnosed with TIA for rapid evaluation, but these data suggest that some demographic groups are less likely to be admitted with TIA than others. We suspect that the differences are related to physician and patient behavior. In particular, blacks, particularly black men, may be less likely to obtain emergency care for TIA symptoms than whites or Hispanics. If confirmed, this finding would support targeting resources for public education on TIA to black Americans. 733 Acute cerebrovascular events (ACE): TIA and minor strokes Metabolomic profiling of patients with recurrent transient ischemic attack G. Mauri-Capdevila1, M. Jové2, I. Suárez3, S. Cambray4, J. Egea5, J. Sanahuja6, C. González7, A. Quílez8, I. Benabdelhak9, M. Codina10, M. Portero-Otín11, F. Purroy12 Institut de Recerca Biomèdica de Lleida. Servei de Neurologia del Hospital Universitari Arnau de Vilanova, Lleida, SPAIN1, Institut de Recerca Biomèdica de Lleida, Lleida, SPAIN2, Institut de Recerca Biomèdica de Lleida, Lleida, SPAIN3, Institut de Recerca Biomèdica de Lleida, Lleida, SPAIN4, Institut de Recerca Biomèdica de Lleida, Lleida, SPAIN5, Institut de Recerca Biomèdica de Lleida. Servei de Neurologia del Hospital Universitari Arnau de Vilanova, Lleida, SPAIN6, Institut de Recerca Biomèdica de Lleida. Servei de Neurologia del Hospital Universitari Arnau de Vilanova, Lleida, SPAIN7, Institut de Recerca Biomèdica de Lleida. Servei de Neurologia del Hospital Univer-sitari Arnau de Vilanova, Lleida, SPAIN8, Institut de Recerca Biomèdica de Lleida. Servei de Neuro-logia del Hospital Universitari Arnau de Vilanova, Lleida, SPAIN9,Institut de Recerca Biomèdica de Lleida. Servei de Neurologia del Hospital Universitari Arnau de Vilanova, Lleida, SPAIN10, Institut de Recerca Biomèdica de Lleida, Lleida, SPAIN11, Institut de Recerca Biomèdica de Lleida. Servei de Neurologia del Hospital Universitari Arnau de Vilanova, Lleida, SPAIN12 BACKGROUND Transient ischemic attack (TIA) is associated with high risk of early stroke recurrence (SR). The presence of large artery atherosclerosis (LAA) is the main established prognostic predictor. How-ever, only few biological biomarkers have been reported as useful in the prognosis of TIA patients. New techniques of massive simple analysis, such as metabolomics, are now available providing the opportunity to identify new biomakers as well as potential novel pathogenic pathways. The aim of the present study was to perform a metabolomic analysis of a cohort of TIA patients in order to find new biomarkers to identify TIA with SR and TIA with LAA. METHODS A nontargeted metabolomic profile was performed in plasma from 131 consecutive TIA patients, of which 20(15.27%) had a SR after median follow-up of 36.9 months. Metabolomic analysis of plasma obtained during the first 24 hours after symptoms onset, was established using an ultra high-pressure liquid chromatography coupled to an electrospray-ionization quadrupole time of flight mass spectrometer. Identity of metabolites was confirmed by isotope pattern distribution and coelu-tion with authentic standards. RESULTS LAA was present in 33(25.2%) patients. After metabolomic analysis we observed changes in plas-ma levels of several metabolites were linked to SR comprising anandamide, eicosapentaenoic acid, 1-monopalmitin, 2-aminohexadecanoic acid, dodecanoic acid, erythriol, threonate, and uridine mo-nophosphate. An evaluation of data through ANOVA analyses established that early SR (at 90 days) could show a specific metabolomic signature characterized by changes in fatty acids biosynthesis and D-glutamine and D-glutamate metabolism. Finally, several metabolites such as androsterone, stearic acid and ascorbic acid were upregulated in patients with LAA. CONCLUSION This data demonstrated the feasibility and utility of the omic approach to identify TIA patients with SR, potentially defining a metabolomic signature of this condition.
Karger_ESC London_2013
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