London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 723 715 Acute cerebrovascular events (ACE): TIA and minor strokes Differences in Risk Factors Profile in Caucasian and South Asian People Presenting to a spe-cialist TIA Clinic? K. Musarrat1, D. Eveson2, A. Mistri3 Leicester Royal Infirmary, Leicester, UNITED KINGDOM1, Leicester Royal Infirmary, Leices-ter, UNITED KINGDOM2, Leicester Royal Infirmary, Leicester, UNITED KINGDOM3 Background There are a number of papers published on the differences of risk factor profiles between Caucasian (C) and South Asian (SA) stroke patients. However, there is no data on ethnic differences in patients presenting with a transient ischaemic attack (TIA). Method We compared risk factor profile in C and SA patients presenting to a specialist TIA clinic in Leices-tershire, UK. Variables included: age, blood glucose (finger prick test), blood pressure, total choles-terol levels, degree of carotid artery stenosis, history of smoking, alcohol intake, atrial fibrillation, diabetes, hypertension and hypercholesterolaemia. Independent t-test and chi-squared test were used. Results 1967 Caucasian and 225 South Asian patients were diagnosed to have a TIA or minor stroke. Com-pared to C, SA present at an earlier age (66 vs 73 years, p<0.001), and have a higher prevalence of diabetes (44 vs 15%, p<0.001), hypercholesterolaemia (30 vs 22%, p=0.009) and hypertension (61 vs 50%, p=0.01). Conversely, C have a higher prevalence of atrial fibrillation (10 vs 1%, p<0.001), smoking (55% vs 27%, p<0.001), excessive alcohol intake (8% vs 0.05%, p<0.001) and carotid ar-tery stenosis (13 vs 8%, p=0.04). SA had higher blood glucose (7.6 vs 6.3mmol/L, p<0.001) and lower total cholesterol level (4.5 vs 4.8mmol/L, p=0.001) with no significant groups difference in blood pressure. Logistic regression indicated that the association was partly explained by the differ-ence in age between the groups. Conclusion South Asians have a higher prevalence of diabetes, hypertension and hypercholesterolaemia, while Caucasians have a higher prevalence of atrial fibrillation and carotid stenosis, and this is partly ex-plained by the younger age at presentation of South Asian. In addition,Caucasians have a higher prevalence of lifestyle risk factors like smoking and excessive alcohol consumption. Further re-search is required to identify the causes and potential interventions to minimise the identified differ-ences. 716 Acute cerebrovascular events (ACE): TIA and minor strokes DEVELOPMENT OF A RAPID ASSESSMENT TIA SERVICE L. Brewer1, L. Weekes2, J. Moroney3, D. Williams4 Royal College of Surgeons in Ireland, Dublin, IRELAND1, Beaumont Hospital, Dublin, IRE-LAND2, Beaumont Hospital, Dublin, IRELAND3, Beaumont Hospital, Dublin, IRELAND4 Transient ischaemic attack is (TIA) may be associated with a high risk of early recurrent stroke. Ur-gent clinical assessment of all TIA patients is essential but the addition of brain imaging, cardiac in-vestigations and neurovascular imaging can optimise risk stratification of patients. This allows phy-sicians to individualise the management of patients. There is no international consensus on where and how this rapid evaluation should take place. Beaumont Hospital is a large tertiary referral centre with a well established stroke service. In Janu-ary 2012 a TIA service was established in conjunction with the appointment of a TIA nurse special-ist. We established a local protocol (outlining the pathway of care for all patients presenting acutely with TIA) and an education programme for physicians within the emergency department (ED) out-lining the urgency of assessment and referral of these patients to the stroke team. There is a strong admission policy in our centre for patients who cannot be urgently investigated as outpatients, re-gardless of the ABCD2 score. 80 patients (42M: 38F) with TIA were assessed by our service in the year commencing January 2012. Mean age was 70 years (range 48-93). Almost all (92.5%) were referred through ED with the remainder receiving their initial assessment in the stroke outpatient clinic. The most prevalent risk factors were hypertension (80%) and hypercholesterolaemia (69%). 10 patients (12.5%) had an acute cerebral infarct on diffusion-weighted MRI. The mean length of hospital stay was reduced by 2 days over the course of the year. A significant number of TIA patients had an ischaemic infarct on neuroimaging, emphasising the need for rapid assessment and management of these high risk patients. Lack of availability of ur-gent outpatient investigations necessitates the admission of many TIA patients. With careful service co-ordination and planning, waiting times for such investigations (and length of stay) can be effec-tively reduced.
Karger_ESC London_2013
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