SILENT BRAIN INFARCTS AND TRANSIENT ISCHEMIC ATTACKS - A 3-YEAR STUDYOF FIRST-EVER ISCHEMIC STROKE PATIENTS - THE KLOSTERNEUBURG STROKE DATA-BANK

Background and Purpose We undertook to study the clinical relevance of silent strokes and history of transient ischemic attacks (TIAs) and t heir individual and combined effects on outcome variables of neurologi cal and epidemiological interest in first-ever stroke patients. Method s We performed univariate and multivariate analyses of data prospectiv ely collected in the Klosterneuburg Stroke Data Bank, a hospital-based registry in Austria that includes a 3-year follow-up program. Results Of 728 patients (mean age, 68 +/- 10 years) with a first-ever ischemi c stroke, 110 (15%) had had a previous TIA, and 66/618 (11%) patients did not have a history of TIA but showed evidence of silent brain infa rct on CT. Outcome variables of neurological interest were not signifi cantly different between groups, including time between stroke and stu dy entry, activities of daily living status at first presentation, med ian time of hospitalization, 30-day mortality, or 3-year mortality. Un ivariate analyses of epidemiologically important risk factors showed e ither history of TIA or evidence of silent infarct to be more frequent ly associated with hypertension (P = .007). Cox models of survival sho wed that neither history of TIA nor evidence of silent infarct were si gnificantly associated with an increase in 3-year mortality. Conclusio ns Over a period of 3 years, neither history of TIA nor evidence of si lent infarct diagnosed at the time of the presenting major stroke in f irst-ever ischemic stroke patients exert an important influence on neu rological or epidemiological outcome variables.