75VASCULAR RISK IN PATIENTS PRESENTING WITH TRANSIENT ISCHAEMIC ATTACK (TIA)

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Abstract

Introduction: Transient Ischaemic Attacks (TIA) carry a significant risk of subsequent TIA and stroke. Identifying high risk patients who are likely to sustain another event is crucial. Arterial stiffness is an independent predictor of cardiovascular events including stroke, however its ability to predict TIA is yet to be investigated. Central aortic pressure is emerging as a predictor of cardiovascular events rather than peripheral blood pressure (BP). This study investigated the prevalence of arterial stiffness and BP characteristics in a population who have suffered a TIA.

Methods: Twenty-four participants with a mean age of 70 years (SD ± 10.1) and a confirmed diagnosis of TIA were recruited from Brighton and Sussex University Hospitals (BSUH) Trust. Carotid-femoral pulse wave velocity (C-F PWV) and carotid-radial pulse wave velocity (C-R PWV) were measured using Complior®. These were compared with published normal values.[1,2] Aortic central BP and brachial BP were measured using Arteriograph®. Twenty-four hour ambulatory BP monitoring (ABPM) was recorded using Diasys®.

Results: Mean PWVs were: C-F 11.5 ±3.18 m/s, C-R 10.8 ±1.26 m/s. C-F and C-R PWVs of TIA participants were higher than measurements in the published normal values (C-F 10.9 m/s, C-R 10.1 m/s). Central aortic BP was higher than peripheral BP (mean difference= 2 mmHg), compared to the normally expected drop of 10-15 mmHg. Thirty-eight per cent of TIA participants on 24-hour ABPM lacked nocturnal dipping compared to 19% healthy subjects (p = n/s).

Conclusions: In the cohort studied, those who suffered a TIA had a tendency towards an increase in central aortic arterial stiffness and central BP and were more likely to lack nocturnal BP dipping compared to healthy subjects.

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