Introduction: After ischaemic stroke (IS) or TIA, recurrence and moderate/major bleeding are each associated with worse outcome. We compared baseline characteristics and outcomes for patients who did and did not have recurrence or bleeding using data from the ongoing TARDIS trial.
Method: TARDIS is assessing the safety and efficacy of intensive vs guideline antiplatelet agents in 4,100 patients with acute non-cardioembolic IS or TIA. Information on bleeding, and recurrent IS and TIA is collected up to day 90. Functional outcome are assessed centrally with blinding to treatment assignment at day 90. Data are unadjusted odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI), and do not take account of treatment assignment.
Results: In 2697 recruited patients (of a planned 4100), recurrent events (178, 6.6%) were more common in patients with a qualifying event of TIA (p=0.017). Major (51 patients, 1.9%), including fatal (7 patients, 0.3%) bleeding were uncommon. Patients with a recurrence or moderate/major bleeding event had worse outcomes at day 90 than those without such events: more deaths, dependency (modified Rankin Scale), disability (Barthel Index), cognitive impairment (TICS-M), worse quality of life (EQ-5D HUS) and more mood disturbance (Zung depression scale) - all comparisons p<0.001.
Conclusion: Recurrent events are more common after TIA. Both recurrence and bleeding are associated with a worse outcome.