Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis

Stroke is a leading cause of mortality and disability worldwide. Transient ischemic attack (TIA) is defined as transient brain ischemia with temporary neurological deficits. In animal models, prior TIA seems to enhance brain ischemic tolerance to withstand further ischemic events, which might be exp...

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Autores principales:	Sherief Ghozy, Salah Eddine Oussama Kacimi, Mohammed Elfil, Mohamed Gomaa Sobeeh, Abdullah Reda, Kevin M. Kallmes, Alejandro A. Rabinstein, David R. Holmes, Waleed Brinjikji, Ramanathan Kadirvel, David F. Kallmes
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	ischemic attack transient stroke neuroprotection ischemic preconditioning meta-analysis Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3d4837d00cef419e8513d75f3832e980
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spelling	oai:doaj.org-article:3d4837d00cef419e8513d75f3832e9802021-11-30T18:55:46ZTransient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis1664-229510.3389/fneur.2021.755167https://doaj.org/article/3d4837d00cef419e8513d75f3832e9802021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.755167/fullhttps://doaj.org/toc/1664-2295Stroke is a leading cause of mortality and disability worldwide. Transient ischemic attack (TIA) is defined as transient brain ischemia with temporary neurological deficits. In animal models, prior TIA seems to enhance brain ischemic tolerance to withstand further ischemic events, which might be explained by brain preconditioning. Thus, this review aims to formulate evidence of whether TIAs can induce positive preconditioning and enhance the functional outcomes in patients suffering from subsequent ischemic strokes. Five databases were searched (PubMed, Embase, SAGE, Web of Science, and Scopus), and twelve studies were included in the quantitative analysis. Studies were eligible when comparing patients with acute ischemic stroke (AIS) and previous TIA with those with AIS without TIA. Comparisons included the National Institute of Health Stroke Scale (NIHSS) score at admission and 7 days from the stroke event, modified Rankin score (mRS), and Trial of ORG 10,172 in Acute Stroke Treatment (TOAST) classification. Odds ratio (OR), mean difference (MD), and 95% confidence interval (CI) were used to describe our results using the random effect model. Our results revealed that patients with stroke and prior TIAs had lower NIHSS scores at admission than those without prior TIAs. However, the NIHSS score was not significantly different between the two groups at 7 days. Furthermore, there was no statistically significant difference between both groups in terms of mortality. Despite the differences in the admission mRS score groups, patients with prior TIAs had lower mRS scores at discharge.Sherief GhozySalah Eddine Oussama KacimiMohammed ElfilMohamed Gomaa SobeehMohamed Gomaa SobeehAbdullah RedaKevin M. KallmesKevin M. KallmesAlejandro A. RabinsteinDavid R. HolmesWaleed BrinjikjiWaleed BrinjikjiRamanathan KadirvelDavid F. KallmesFrontiers Media S.A.articleischemic attacktransientstrokeneuroprotectionischemic preconditioningmeta-analysisNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ischemic attack transient stroke neuroprotection ischemic preconditioning meta-analysis Neurology. Diseases of the nervous system RC346-429
spellingShingle	ischemic attack transient stroke neuroprotection ischemic preconditioning meta-analysis Neurology. Diseases of the nervous system RC346-429 Sherief Ghozy Salah Eddine Oussama Kacimi Mohammed Elfil Mohamed Gomaa Sobeeh Mohamed Gomaa Sobeeh Abdullah Reda Kevin M. Kallmes Kevin M. Kallmes Alejandro A. Rabinstein David R. Holmes Waleed Brinjikji Waleed Brinjikji Ramanathan Kadirvel David F. Kallmes Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis
description	Stroke is a leading cause of mortality and disability worldwide. Transient ischemic attack (TIA) is defined as transient brain ischemia with temporary neurological deficits. In animal models, prior TIA seems to enhance brain ischemic tolerance to withstand further ischemic events, which might be explained by brain preconditioning. Thus, this review aims to formulate evidence of whether TIAs can induce positive preconditioning and enhance the functional outcomes in patients suffering from subsequent ischemic strokes. Five databases were searched (PubMed, Embase, SAGE, Web of Science, and Scopus), and twelve studies were included in the quantitative analysis. Studies were eligible when comparing patients with acute ischemic stroke (AIS) and previous TIA with those with AIS without TIA. Comparisons included the National Institute of Health Stroke Scale (NIHSS) score at admission and 7 days from the stroke event, modified Rankin score (mRS), and Trial of ORG 10,172 in Acute Stroke Treatment (TOAST) classification. Odds ratio (OR), mean difference (MD), and 95% confidence interval (CI) were used to describe our results using the random effect model. Our results revealed that patients with stroke and prior TIAs had lower NIHSS scores at admission than those without prior TIAs. However, the NIHSS score was not significantly different between the two groups at 7 days. Furthermore, there was no statistically significant difference between both groups in terms of mortality. Despite the differences in the admission mRS score groups, patients with prior TIAs had lower mRS scores at discharge.
format	article
author	Sherief Ghozy Salah Eddine Oussama Kacimi Mohammed Elfil Mohamed Gomaa Sobeeh Mohamed Gomaa Sobeeh Abdullah Reda Kevin M. Kallmes Kevin M. Kallmes Alejandro A. Rabinstein David R. Holmes Waleed Brinjikji Waleed Brinjikji Ramanathan Kadirvel David F. Kallmes
author_facet	Sherief Ghozy Salah Eddine Oussama Kacimi Mohammed Elfil Mohamed Gomaa Sobeeh Mohamed Gomaa Sobeeh Abdullah Reda Kevin M. Kallmes Kevin M. Kallmes Alejandro A. Rabinstein David R. Holmes Waleed Brinjikji Waleed Brinjikji Ramanathan Kadirvel David F. Kallmes
author_sort	Sherief Ghozy
title	Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis
title_short	Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis
title_full	Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis
title_fullStr	Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis
title_full_unstemmed	Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis
title_sort	transient ischemic attacks preceding ischemic stroke and the possible preconditioning of the human brain: a systematic review and meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/3d4837d00cef419e8513d75f3832e980
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Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis

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