Mini Strokes: Temporary Episodes Shorten Lives

PHOTO: Mini strokes or TIAs temporarily cut off blood flow to the brain, typically causing problems for an hour or two.
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The tiny lapses in blood flow to the brain commonly called mini strokes aren't fatal, but can shorten your life, according to new findings from Australian researchers.

Also known as TIAs, transient ischemic attacks can result from blood clots or from narrowed or injured vessels that supply blood to the brain. The resulting stroke-like symptoms typically resolve after an hour or two. Scientists have long known TIAs boost the risk of stroke. However, they didn't have any large, recent studies calculating their toll on longevity.

A team led by Melina Gattellari, a senior lecturer in public health and community medicine at the University of New South Wales, on Thursday published estimates of TIAs' life-shortening effects. After one year, a TIA shaved 4 percent off life expectancy. By the time 9 years had passed, the TIA shaved away about 20 percent.

Unfortunately, Gattellari said, she couldn't translate those statistical reductions into "lost years."

TIAs had a minimal effect on the longevity of people under 50. However, survival rates progressively declined as TIA patients aged. In addition, the older that patients were when they suffered one of these brain episodes, the worse their survival. As a result, "elderly people may have the most to gain from intensive cardiovascular risk management," the researchers concluded.

TIAs can easily be confused with other maladies, including migraine headaches. Digital news reporter and editor Kara Swisher, a healthy 48-year-old from San Francisco, initially suspected either migraine or jetlag when she began noticing odd sensations, such as tingling in her hands, on Oct. 18, a day after taking a 14-hour flight to Hong Kong. However, when she was talking to herself and the sounds "came out like gibberish," she went to a hospital where doctors diagnosed a TIA as well as a patent foramen ovale, a tiny hole in her heart present from birth. PFOs can produce migraines, TIAs and stroke. The Chinese doctors admitted her to the hospital and began giving her the blood thinner Lovenox (enoxaparin) to prevent a recurrence. Blood thinners are a TIA treatment mainstay.

The new findings, released Thursday in Stroke: Journal of the American Heart Association, came from the Program of Research Informing Stroke Management (PRISM) study. Gattellari's group analyzed cases of 22,157 Australian adults hospitalized with a TIA from July 1, 2000, to June 30, 2007, and followed them two to nine years. They linked the cases with death records through June 30, 2009, then compared the TIA patients' survival with expected survival for adults of the same sex and age.

Gattellari and her colleagues found that nearly 10 percent of patients hospitalized for a TIA died within a year (compared with 5 percent in the general population). By five years, more than 30 percent of TIA sufferers were dead (vs. 20 percent of the general population). By nine years, nearly half the TIA sufferers had died, their survival falling 20 percent below that of men and women without TIAs.

With each passing year after a TIA, the gap between patients' survival and expected survival widened. After one year, women fared a bit better than men, but by 5 years out, survival rates evened out for the sexes.

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