Medium-term prognosis

Since the above review, two further high-quality, prospective, population-based studies of the medium-term prognosis of TIA have been published, one from Soderhamn, Sweden (97 patients, follow-up over three years) (Terent 1990) and the other from Perugia, Italy (94 patients, follow-up over nine years) (Ricci et al. 1998). The mean age of patients in all three cohorts was 69 years. 

In the same way that data on the short-term risk of stroke following TIA are essential for informing the early management of patients, data on the medium-term (one to five years) and long-term (five years and beyond) prognosis are required to counsel patients and direct secondary prevention. 

These studies indicate that, the risk of stroke and other vascular events is appreciable in the medium term, but a question that has recently been addressed is the vascular risk in the longer term and whether there is a need for ongoing aggressive secondary prevention. Only two studies provide reliable data on prognosis up to 15 years after a TIA. 

From these studies, it appears that the medium- and long-term prognosis after TIA is more dependent on underlying vascular risk factors than characteristics of the event itself. 

---