MedWire News: Patients are less likely to die of an ischemic stroke if they previously suffered a transient ischemic attack (TIA), research suggests.

The finding fits with the theory that a mild ischemic insult renders cells more resistant to a subsequent serious ischemic event.

Judit Zsuga (University of Debrecen, Hungary) and colleagues analyzed data from a prospective stroke database. Of the 2874 patients studied, 673 had previous stroke and 195 had previous TIA.

Patients with previous TIA were at reduced risk for dying from their stroke, with 7.7% dying in-hospital, the team reports in the journal Psychiatry and Clinical Neurosciences.

By comparison, 13.4% of patients with first-ever stroke and 20.9% of those with previous stroke died in-hospital.

Previous TIA was associated with a 47% reduction in the risk for in-hospital case–fatality after accounting for confounders including age, smoking status, serum glucose and triglyceride levels, and the presence of hypertension and atrial fibrillation.

Previous stroke was associated with a nonsignificant 26% increase in case–fatality risk. Significant predictors of in-hospital death were advanced age, male gender, and elevated glucose levels.

“The effect of overly aggressive therapeutic interventions against mild ischemic episodes should be re-evaluated,” recommend the researchers.

“Additionally, efforts should be made to identify the cellular and molecular mechanisms underlying this phenomenon to exploit these mechanisms, yielding safer and more effective stroke therapies.”

Free abstract