People who have a minor ischemic stroke have a greater than 40-percent risk for another stroke or vascular event in the next 10 years, according to an article in the July 7 issue of Lancet.

Dr. I. van Wijk, lead author, and his Dutch colleagues assessed the survival status and occurrence of vascular events in over 2400 patients recruited from 24 hospitals. They found that, roughly 10 years after a transient ischemic attack or minor ischemic stroke, about 60 percent of patients had died and 54 percent had experienced at least one new vascular event. Event-free survival after 10 years was 48 percent.

The risk of a vascular event was highest shortly after the ischemic event, reached its lowest point at about three years, and gradually rose afterward.

Professor Ale Algra, senior study author, concluded: “Throughout our study, the risk of mortality gradually rose, whereas that of stroke fell in the first three years and remained constant thereafter . . . These findings imply that further improvement can still be established on long-term secondary prevention of vascular disease in patients with cerebral ischemia.”

In an accompanying Commentary, Dr. Graeme Hanky (Royal Perth Hospital, Australia) wrote “The implications of van Wijk and colleagues’ study, which can confidently be generalized to other hospital-referred patients, are that patients with transient ischemic attack and minor ischemic stroke should be repeatedly assessed (because their risk can change), treated to prevent cerebrovascular and cardiovascular events, and treated long-term.”