Introduction: Patients experiencing a mild ischemic stroke (MIS) or transient ischemic attack (TIA) are at high risk of further events in the next 90 days. A good understanding of the unmet medical needs in these patients is required to develop evidenced-based treatment options that may improve post-stroke outcomes.
Aims: This systematic literature review aimed to assess 90-day outcomes in patients following an MIS in routine clinical practice.
Methods: Ovid MEDLINE and Embase were searched using terms relating to disease, severity and outcomes. Key inclusion criteria were: ≥ 100 patients with MIS (NIHSS score ≤ 5); 90-day outcomes reported; and non-interventional study design.
Results: In total, 6510 records were identified. Of these, 18 articles reporting outcomes from 16 studies were included in the review. Stroke recurrence at 90 days, reported by 7 studies, varied widely (0.9-24.6%; Table); there were differences in study size, recurrence definition and time to presentation. Mortality at 90 days was 0.2-5.1% (13 studies), with a trend towards higher mortality in studies using higher NIHSS cut-off values to define MIS. Most patients had modified Rankin Scale scores of 0-1 (6 studies) or 0-2 (5 studies) at 90 days.
Conclusions: The rates of 90-day stroke recurrence in patients following an MIS identified in this comprehensive literature review suggest there is a need for improvement in current clinical practice. However, identified studies reporting stroke recurrence had varied methodologies. Further standardized studies in these patients may be needed to better understand stroke recurrence, severity and mortality.