{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:39:29Z","timestamp":1760143169852,"version":"build-2065373602"},"reference-count":14,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Perioperative transient ischemic attacks (PTIAs) are associated with significantly increased rates of postoperative complications such as low cardiac output, atrial fibrillation, and significantly higher mortality in cardiac procedures. The current literature on PTIAs is sparse and understudied. Therefore, we aim to understand the effects of PTIA on hospital utilization, readmission, and morbidity. Using data on all the cardiac procedures at the University of Pittsburgh Medical Center from 2011 to 2019, fine and gray analysis was performed to identify whether PTIAs and covariables correlate with increased hospital utilization, stroke, all-cause readmission, Major Adverse Cardiac and Cerebrovascular Events (MACCE), MI, and all-cause mortality. Logistic regression for longer hospitalization showed that PTIA (HR: 2.199 [95% CI: 1.416\u20133.416] increased utilization rates. Fine and gray modeling indicated that PTIA (HR: 1.444 [95% CI: 1.096\u20131.902], p &lt; 0.01) increased the rates of follow-up all-cause readmission. However, PTIA (HR: 1.643 [95% CI: 0.913\u20132.956] was not statistically significant for stroke readmission modeling. Multivariate modeling for MACCE events within 30 days of surgery (HR: 0.524 [95% CI: 0.171\u20131.605], p &gt; 0.25) and anytime during the follow-up period (HR: 1.116 [95% CI: 0.825\u20131.509], p &gt; 0.45) showed no significant correlation with PTIA. As a result of PTIA\u2019s significant burden on the healthcare system due to increased utilization, it is critical to better define and recognize PTIA for timely management to improve perioperative outcomes.<\/jats:p>","DOI":"10.3390\/jcdd11010027","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T04:16:56Z","timestamp":1705465016000},"page":"27","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes after Perioperative Transient Ischemic Attack Following Cardiac Surgery"],"prefix":"10.3390","volume":"11","author":[{"given":"Urvish","family":"Jain","sequence":"first","affiliation":[{"name":"School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-4894","authenticated-orcid":false,"given":"Bhav","family":"Jain","sequence":"additional","affiliation":[{"name":"School of Medicine, Stanford University, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim B.","family":"Sultan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Floyd","family":"Thoma","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine M.","family":"Anetakis","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey R.","family":"Balzer","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathirvel","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2333-1086","authenticated-orcid":false,"given":"Sarah","family":"Yousef","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yisi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parthasarathy D.","family":"Thirumala","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"},{"name":"Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"ref_1","first-page":"242","article-title":"Incidence and predictors of tias and strokes following coronary artery bypass grafting: Report and collective review","volume":"2","author":"Engelman","year":"1999","journal-title":"Heart Surg. Forum"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2901","DOI":"10.1001\/jama.284.22.2901","article-title":"Short-term Prognosis After Emergency Department Diagnosis of TIA","volume":"284","author":"Johnston","year":"2000","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"518621","DOI":"10.5402\/2011\/518621","article-title":"The ABCD and ABCD2 Scores and the Risk of Stroke following a TIA: A Narrative Review","volume":"2011","author":"Bhatt","year":"2011","journal-title":"ISRN Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"464","DOI":"10.3171\/JNS\/2008\/108\/3\/0464","article-title":"Risk of intraoperative ischemia due to temporary vessel occlusion during standard extracranial\u2013intracranial arterial bypass surgery","volume":"108","author":"Horn","year":"2008","journal-title":"JNS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.athoracsur.2014.05.104","article-title":"The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons General Thoracic Surgery Databases: Joint Standardization of Variable Definitions and Terminology","volume":"99","author":"Fernandez","year":"2015","journal-title":"Ann. Thorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e010764","DOI":"10.1136\/bmjopen-2015-010764","article-title":"Factors associated with prolonged length of stay following cardiac surgery in a major referral hospital in Oman: A retrospective observational study","volume":"6","author":"Almashrafi","year":"2016","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1001\/jamacardio.2020.0239","article-title":"Long-term Outcomes in Patients With Severely Reduced Left Ventricular Ejection Fraction Undergoing Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting","volume":"5","author":"Sun","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e010541","DOI":"10.1161\/JAHA.118.010541","article-title":"Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population","volume":"8","author":"Choi","year":"2019","journal-title":"JAHA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1007\/s00415-009-5053-2","article-title":"Evaluation of costs and outcome in cardioembolic stroke or TIA","volume":"256","author":"Winter","year":"2009","journal-title":"J. Neurol."},{"key":"ref_10","first-page":"82","article-title":"Diagnosis and Management of Transient Ischemic Attack","volume":"23","author":"Coutts","year":"2017","journal-title":"Continuum (Minneap. Minn.)"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1212\/WNL.57.2.305","article-title":"Inpatient costs, length of stay, and mortality for cerebrovascular events in community hospitals","volume":"57","author":"Reed","year":"2001","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jns.2011.05.022","article-title":"Why do ischemic stroke and transient ischemic attack patients get readmitted?","volume":"307","author":"Bhattacharya","year":"2011","journal-title":"J. Neurol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8333","DOI":"10.1038\/s41598-023-35601-x","article-title":"Long-term risk of major adverse cardiovascular events following ischemic stroke or TIA","volume":"13","author":"Carlsson","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e063268","DOI":"10.1136\/bmjopen-2022-063268","article-title":"Outcome Monitoring After Cardiac Surgery (OMACS): A single-centre prospective cohort study of cardiac surgery patients","volume":"12","author":"Joyce","year":"2022","journal-title":"BMJ Open"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/1\/27\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:48:37Z","timestamp":1760104117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/1\/27"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,17]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcdd11010027"],"URL":"https:\/\/doi.org\/10.3390\/jcdd11010027","relation":{},"ISSN":["2308-3425"],"issn-type":[{"type":"electronic","value":"2308-3425"}],"subject":[],"published":{"date-parts":[[2024,1,17]]}}}