Previous research has demonstrated that, following a transient ischemic attack (TIA), untreated patients have an increased risk of stroke, with recurrence rates by 90 days of up to 17%. Studies have also demonstrated that urgent intervention after TIA is associated with a significant reduction in the short-term risk of stroke. This study evaluated the three-year outcomes of patients treated with a predefined clinical pathway of urgent care after TIA.

Subjects included consecutive patients with TIA, diagnosed by vascular neurologists. The expedited protocol was implemented within 24 hours, with measures including ; antiplatelet therapy (aspirin 100 mg per day) initiated immediately, except in patients with a cardioembolic origin where anticoagulants were the first choice; antihypertensive therapy to obtain a target level of less than 140/80, and 135/85 in nondiabetic and diabetic patients respectively; statins prescribed to achieve a low density lipoprotein target of 100 mg/dl or less in moderate, and 70 mg/dl or less in high vascular risk profile patients.

Subjects were 686 patients, of whom 63% had confirmed TIA. Stroke occurred in 90 days in nine patients, seven within 24 hours. The risk of stroke was 2.6%, 3.7% and 4.4%, at 12, 24 and 36 months, respectively. The composite outcomes of stroke, myocardial infarction or vascular death were 3.5% 4.9% and 5.6% at 12, 24 and 36 months, respectively.

This study of patients with transient ischemic attacks found that a rapid care model of urgent intervention can reduce the risk of subsequent stroke.