{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:12Z","timestamp":1787018112460,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"\n Background<\/jats:title>\n \n The ABCD\n 2<\/jats:sup>\n score, used to triage patients with transient ischemic attack (TIA), was developed before contemporary use of dual antiplatelet therapy (DAPT) and therefore estimates pretreatment stroke risk. However, posttreatment stroke risk after DAPT may be more relevant for clinical triage. We aimed to quantify residual ischemic stroke risk following DAPT in patients with high\u2010risk TIA.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a post hoc analysis of high\u2010risk patients with TIA enrolled in the POINT (Platelet\u2010Oriented Inhibition in New TIA and Minor Ischemic Stroke) trial who were treated with DAPT. We calculated Kaplan\u2013Meier estimates of ischemic stroke risk at 2, 7, and 90\u2009days. Risk estimates were further stratified according to ABCD\n 2<\/jats:sup>\n category (4\u20135 versus 6\u20137) and presence of infarct on index imaging despite symptom resolution. Observed risks were compared with ABCD\n 2<\/jats:sup>\n predictions.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1052 POINT participants experienced a TIA and were treated with DAPT. Cumulative ischemic stroke risks were 1.3% (95% CI, 0.6\u20131.9) at 2\u2009days, 2.0% (95% CI, 1.2\u20132.9) at 7\u2009days, and 4.1% (95% CI, 2.8\u20135.3) at 90\u2009days, all below ABCD\n 2<\/jats:sup>\n \u2010predicted risks of 5.1, 7.4, and 11.9%, respectively. Incident ischemic stroke risk did not differ by ABCD\n 2<\/jats:sup>\n category (\n P<\/jats:italic>\n =0.80) but was higher in those with acute infarct on index imaging (\n P<\/jats:italic>\n =0.02). In patients with infarct on imaging despite symptom resolution, 2\u2010day ischemic stroke risk (3.4% [95% CI, 0.1\u20136.1]) approximated ABCD\n 2<\/jats:sup>\n risk predictions, whereas those without evidence of infarct were at 6\u2010fold lower 2\u2010day risk (0.8% [95% CI, 0.0\u20131.4]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n High\u2010risk patients with TIA treated with DAPT had substantially lower early stroke risk than predicted by ABCD\n 2<\/jats:sup>\n , particularly in the absence of acute infarct on neuroimaging.\n <\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n \n URL:\n https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n ; Unique Identifier: NCT00991029.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.125.047068","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:21:21Z","timestamp":1771590081000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Observed Versus Predicted Stroke Risk After Transient Ischemic Attack: A Post Hoc Analysis of a Randomized Clinical Trial"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6924-0641","authenticated-orcid":false,"given":"Iyas","family":"Daghlas","sequence":"first","affiliation":[{"name":"University of California San Francisco","place":["San Francisco"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6641-1086","authenticated-orcid":false,"given":"Michelle R.","family":"Caunca","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-6517","authenticated-orcid":false,"given":"Anthony S.","family":"Kim","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60150-0"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12129"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1215340"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1916870"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000187067.93321.fa"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000418"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1800410"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.4905"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061894"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000375"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.25071"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.3627"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412981"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.047068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:07:52Z","timestamp":1782990472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.047068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,3,3]]}},"alternative-id":["10.1161\/JAHA.125.047068"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.047068","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]},"assertion":[{"value":"2025-10-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e047068"}}