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The following is a summary of “Incident Stroke After First-Time TIA According to ABCD² Score: A Nationwide Cohort Study,” published in the November 2024 issue of Neurology by Al-Chaer et al.   

A transient ischemic attack (TIA) is linked to a higher short-term risk of ischemic stroke. However, long-term data on the association are lacking.  

Researchers conducted a retrospective study analyzing the long-term incidence of ischemic stroke following first-time TIA based on the ABCD² score.  

They included all individuals in Denmark aged 18 years and older with a first-time TIA from the Danish Stroke Registry (2014–2020). Participants were grouped by a modified ABCD² score (≥4 points as high-risk, <4 points as low-risk). The 3-year cumulative incidence of stroke and all-cause mortality was estimated using the Aalen-Johansen and Kaplan-Meier methods, respectively. Multivariable Cox regression models identified factors linked with a 3-year stroke risk.  

The result showed that the 3-year cumulative incidence of stroke was 6.0% (95% CI, 4.6–7.5) in the high-risk cohort and 4.2% (95% CI, 3.9–4.5) in the low-risk cohort (P=0.004), with an unadjusted hazard ratio of 1.56 (95% CI, 1.21–2.00). Factors associated with stroke included age 60 years and older (HR 2.21, 95% CI, 1.76–2.78), current smoking (HR 1.37, 95% CI, 1.13–1.65), unilateral weakness (HR 1.25, 95% CI, 1.04–1.51), peripheral artery disease (HR 1.53, 95% CI, 1.09–2.14), and chronic kidney disease (HR 1.39, 95% CI, 1.01–1.90). The 3-year cumulative incidence of all-cause mortality was 28.9% (95% CI, 26.1–31.7) in the high-risk cohort and 10.3% (95% CI, 9.9–10.8) in the low-risk cohort.  

They concluded that individuals with a high-risk ABCD² score had a significantly higher long-term stroke risk compared to those with a low-risk score.  

Source: neurology.org/doi/10.1212/WNL.0000000000210053