{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:35:29Z","timestamp":1792690529287,"version":"4.5.0"},"reference-count":13,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:sec id=\"ab-noi230067-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The coexistence of underlying causes in patients with transient ischemic attack (TIA) or minor ischemic stroke as well as their associated 5-year risks are not well known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230067-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To apply the ASCOD (atherosclerosis, small vessel disease, cardiac pathology, other cause, or dissection) grading system to assess coexistence of underlying causes of TIA and minor ischemic stroke and the 5-year risk for major vascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230067-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This international registry cohort (TIAregistry.org) study enrolled 4789 patients from June 1, 2009, to December 31, 2011, with 1- to 5-year follow-up at 61 sites in 21 countries. Eligible patients had a TIA or minor stroke (with modified Rankin Scale score of 0 or 1) within the last 7 days. Among these, 3847 patients completed the 5-year follow-up by December 31, 2016. Data were analyzed from October 1, 2022, to June 15, 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230067-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Five-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230067-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Estimated 5-year risk of the composite outcome of stroke, acute coronary syndrome, or cardiovascular death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230067-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3847 patients (mean [SD] age, 66.4 [13.2] years; 2295 men [59.7%]) in 42 sites were enrolled and participated in the 5-year follow-up cohort (median percentage of 5-year follow-up per center was 92.3% [IQR, 83.4%-97.8%]). In 998 patients with probable or possible causal atherosclerotic disease, 489 (49.0%) had some form of small vessel disease (SVD), including 110 (11.0%) in whom a lacunar stroke was also probably or possibly causal, and 504 (50.5%) had no SVD; 275 (27.6%) had some cardiac findings, including 225 (22.6%) in whom cardiac pathology was also probably or possibly causal, and 702 (70.3%) had no cardiac findings. Compared with patients with none of the 5 ASCOD categories of disease (n\u2009=\u2009484), the 5-year rate of major vascular events was almost 5 times higher (hazard ratio [HR], 4.86 [95% CI, 3.07-7.72];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) in patients with causal atherosclerosis, 2.5 times higher (HR, 2.57 [95% CI, 1.58-4.20];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) in patients with causal lacunar stroke or lacunar syndrome, and 4 times higher (HR, 4.01 [95% CI, 2.50-6.44];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) in patients with causal cardiac pathology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230067-10\">\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>The findings of this cohort study suggest that in patients with TIA and minor ischemic stroke, the coexistence of atherosclerosis, SVD, cardiac pathology, dissection, or other causes is substantial, and the 5-year risk of a major vascular event varies considerably across the 5 categories of underlying diseases. These findings further suggest the need for secondary prevention strategies based on pathophysiology rather than a one-size-fits-all approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaneurol.2023.3344","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T11:01:36Z","timestamp":1696244496000},"page":"1199","source":"Crossref","is-referenced-by-count":22,"title":["Underlying Causes of TIA and Minor Ischemic Stroke and Risk of Major Vascular Events"],"prefix":"10.1001","volume":"80","author":[{"given":"Philippa C.","family":"Lavall\u00e9e","sequence":"first","affiliation":[{"name":"Department of Neurology and Stroke Center, Bichat Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Laboratory for Vascular Translational Science (LVTS)\u2013U1148, University Paris-Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Charles","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, Bichat Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Laboratory for Vascular Translational Science (LVTS)\u2013U1148, University Paris-Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Albers","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences, Stanford Stroke Center, Stanford University Medical Center, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis R.","family":"Caplan","sequence":"additional","affiliation":[{"name":"Cerebrovascular Disease Service, Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey A.","family":"Donnan","sequence":"additional","affiliation":[{"name":"Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Ferro","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes, Universidade de Lisboa, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Hennerici","sequence":"additional","affiliation":[{"name":"Department of Neurology, Universit\u00e4ts Medizin Mannheim, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Labreuche","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, Bichat Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Laboratory for Vascular Translational Science (LVTS)\u2013U1148, University Paris-Cit\u00e9, Paris, France"},{"name":"Department of Biostatistics, Centre Hospitalier Universitaire Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Molina","sequence":"additional","affiliation":[{"name":"Stroke Unit, Department of Neurology, Vall d\u2019Hebron University Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Rothwell","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H\u00f4pital Bichat, Universit\u00e9 Paris Cit\u00e9, AP-HP, INSERM LVTS-U1148, Institut Universitaire de France, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Jean","family":"Touboul","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, Bichat Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Laboratory for Vascular Translational Science (LVTS)\u2013U1148, University Paris-Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, International University of Health and Welfare, Tokyo, 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S.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Amarenco","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, Bichat Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Laboratory for Vascular Translational Science (LVTS)\u2013U1148, University Paris-Cit\u00e9, Paris, France"},{"name":"Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"TIAregistry.org Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ameriso","sequence":"additional","affiliation":[{"name":"for the 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