Background and Purpose: Many studies have been reported about the differences between women and men in acute ischemic stroke, but there was limited data for transient ischemic attack (TIA). The aim of this study was to clarify the sex differences in clinical characteristics and subsequent ischemic stroke in TIA patients.
Methods: The PROMISE-TIA registry was a multicenter prospective study in Japan. From June 2011 to December 2013, 1365 patients within 7 days of TIA onset were enrolled. 1314 patients were followed for 90 days and 1226 patients for 1 year. The age-adjusted hazard ratio (HR) for ischemic stroke after TIA was calculated by using Cox regression to assess sex differences.
Results: Overall, 483 patients were women and 882 were men. Compared with women, men were younger (69±12 years vs. 71±14 years, p=0.005), had more frequently diabetes mellitus (25% vs. 17%, p=0.0007), and had more frequently taken antiplatelet drugs before TIA onset (32% vs. 26%, p=0.002). The current smoking and drinking rate was higher in men than women (29% vs. 8%, p<0.0001, 55% vs. 15%, p<0.0001, respectively). As for the imaging findings, men had more frequently extracranial carotid stenosis (20% vs. 7%, p<0.0001) and positive DWI lesions (35% vs. 29%, p=0.01). The ABCD2 score was similar in both groups but the incidence of ischemic stroke was significantly higher in men than women both 90 days and 1 year (6.6% vs. 4.1%, HR 1.68; 95%CI 1.01-2.90 and 9.3% vs. 4.4%, HR 1.62; 95%CI 1.05-2.58, respectively). There was no significant difference in stroke subtypes between women and men.
Conclusions: Although there was no significant difference in the ABCD2 score between the sexes, men had a higher risk of ischemic stroke within 90 days or 1 year after TIA onset.