Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12380
Title: Absolute cardiovascular risk and GP decision making in TIA and minor stroke.
Authors: Clarey, Jamie;Lasserson, Daniel;Levi, Christopher R;Parsons, Mark W;Dewey, Helen M;Barber, P Alan;Quain, Debbie;McElduff, Patrick;Sales, Milton;Magin, Parker
Affiliation: Discipline of General Practice, University of Newcastle, Newcastle, Australia.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Centre for Translational Neuroscience, University of Newcastle, Newcastle, Department of Neurology, John Hunter Hospital, Newcastle.
Department of Neurology, John Hunter Hospital, Newcastle, School of Medicine and Public Health, University of Newcastle, Newcastle.
Department of Medicine - Austin Health, University of Melbourne, Melbourne, Australia.
Centre for Brain Research Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand and.
School of Medicine and Public Health, University of Newcastle, Newcastle.
General Practice Training valley to coast, Newcastle, Australia.
Discipline of General Practice, University of Newcastle, Newcastle, Australia, Centre for Translational Neuroscience, University of Newcastle, Newcastle, General Practice Training valley to coast, Newcastle, Australia. parker.magin@newcastle.edu.au.
Issue Date: 10-Sep-2014
Citation: Family Practice 2014; 31(6): 664-9
Abstract: Transient ischaemic attacks (TIA) and minor strokes (TIAMS) have the same pathophysiological mechanism as stroke and carry a high risk of recurrent ischaemic events. Diagnosis of TIAMS can be challenging and often occurs in general practice. Absolute cardiovascular risk (ACVR) is recommended as the basis for vascular risk management. Consideration of cardiovascular risk in TIAMS diagnosis has been recommended but its utility is not established.Firstly, to document the ACVR of patients with incident TIAMS and with TIAMS-mimics. Secondly, to evaluate the utility of ACVR calculation in informing the initial diagnosis of TIAMS.The International comparison of Systems of care and patient outcomes in minor Stroke and TIA (InSiST) study is an inception cohort study of patients of 17 Australian general practices presenting as possible TIAMS. An expert panel determines whether participants have had TIAMS or TIAMS-mimics. ACVR was calculated at baseline for each participating patient. In this cross-sectional baseline analysis, ACVR of TIAMS and TIAMS-mimics were compared univariately and, also, when adjusted for age and sex. The diagnostic utility of ACVR was evaluated via receiver operating characteristic (ROC) curves.Of 179 participants, 87 were adjudicated as TIAMS. The presence of motor and speech symptoms and body mass index were associated with a diagnosis of TIAMS. ACVR was associated with TIAMS diagnosis on univariate analysis, but not when age- and sex-adjusted. ACVR did not significantly improve area under ROC curves beyond that of age and sex.In patients presenting with transient or minor neurological symptoms, calculation of ACVR did not improve diagnostic accuracy for TIAMS beyond that of age and sex.
Internal ID Number: 25208544
URI: http://ahro.austin.org.au/austinjspui/handle/1/12380
DOI: 10.1093/fampra/cmu054
URL: http://www.ncbi.nlm.nih.gov/pubmed/25208544
Type: Journal Article
Subjects: Cardiovascular diseases
diagnosis
family practice
risk assessment
stroke
transient ischaemic attack.
Appears in Collections:Journal articles

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