Patients with mixed TNA were at increased risk of stroke, especially ischemic stroke; ischemic heart disease, especially heart attack; and vascular death and dementia, compared with participants without TNA.
Our findings challenge the strong but unfounded conviction that nonfocal TNAs are harmless. On the contrary, our findings suggest that nonfocal TNAs are not only a risk factor for stroke, but also for dementia, the authors write.
(JAMA. 2007;298(24):2877-2885. Available pre-embargo to the media at www.jamamedia.org)
Editors Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Transient Neurological Attack - A Useful Concept?
In an accompanying editorial, S. Claiborne Johnston, M.D., Ph.D., of the University of California, San Francisco, writes that this study reports important new information.
this is the first large-scale study of TNAs, and the findings are intriguing for several reasons. Most patients with nonfocal TNAs are currently treated as though the condition were benign. For some etiologies, such as transient global amnesia, the evidence supports this, but for most of these events, there is no consistent evaluation, no guidelines for treatment, and no information on prognosis. This study argues that, whatever is causing these events, the prognosis justifies greater attention. More needs to be done to identify the TNA patients at greatest risk, to complete evaluations, to rule out important underlying disease, and to continue to study this heterogeneous group.
|Contact: Monique M. B. Breteler, M.D., Ph.D.|
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