Temporal Trends of Sex Differences in Transient Ischemic Attack Incidence Within a Population

doi:10.1016/j.jstrokecerebrovasdis.2019.06.020

Comparative Study

. 2019 Sep;28(9):2468-2474.

doi: 10.1016/j.jstrokecerebrovasdis.2019.06.020. Epub 2019 Jul 1.

Temporal Trends of Sex Differences in Transient Ischemic Attack Incidence Within a Population

Tracy E Madsen¹, Jane C Khoury², Kathleen Alwell³, Charles J Moomaw³, Eric Rademacher⁴, Matthew L Flaherty⁵, Daniel Woo⁶, Felipe De Los Rios La Rosa⁷, Jason Mackey⁸, Sharyl Martini⁹, Simona Ferioli⁶, Opeolu Adeoye¹⁰, Pooja Khatri⁶, Joseph P Broderick⁶, Brett M Kissela⁶, Dawn Kleindorfer⁶

Affiliations

¹ Department of Emergency Medicine, Alpert Medical School of Medicine at Brown University, Providence, Rhode Island. Electronic address: Tracy_Madsen@brown.edu.
² Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio.
³ Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
⁴ Institute for Policy Research, University of Cincinnati, Cincinnati, Ohio.
⁵ Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; Institute for Policy Research, University of Cincinnati, Cincinnati, Ohio.
⁶ Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
⁷ Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; Baptist Health Neuroscience Center, Miami, Florida.
⁸ Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana.
⁹ Department of Neurology, Baylor College of Medicine, Houston, Texas.
¹⁰ Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.

PMID: 31270019
PMCID: PMC6698220
DOI: 10.1016/j.jstrokecerebrovasdis.2019.06.020

Comparative Study

Temporal Trends of Sex Differences in Transient Ischemic Attack Incidence Within a Population

Tracy E Madsen et al. J Stroke Cerebrovasc Dis. 2019 Sep.

. 2019 Sep;28(9):2468-2474.

doi: 10.1016/j.jstrokecerebrovasdis.2019.06.020. Epub 2019 Jul 1.

Authors

Affiliations

¹ Department of Emergency Medicine, Alpert Medical School of Medicine at Brown University, Providence, Rhode Island. Electronic address: Tracy_Madsen@brown.edu.
² Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio.
³ Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
⁴ Institute for Policy Research, University of Cincinnati, Cincinnati, Ohio.
⁵ Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; Institute for Policy Research, University of Cincinnati, Cincinnati, Ohio.
⁶ Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
⁷ Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; Baptist Health Neuroscience Center, Miami, Florida.
⁸ Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana.
⁹ Department of Neurology, Baylor College of Medicine, Houston, Texas.
¹⁰ Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.

PMID: 31270019
PMCID: PMC6698220
DOI: 10.1016/j.jstrokecerebrovasdis.2019.06.020

Abstract

Objective: Previously we reported that ischemic stroke incidence is declining over time for men but not women. We sought to describe temporal trends of sex differences in incidence of transient ischemic attack (TIA) within the same large, biracial population.

Methods: Among the population of 1.3 million in the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) region, TIAs among area residents (≥20 years old) were identified at all local hospitals. Out of hospital cases were ascertained using a sampling scheme. First-ever cases and first within each study period for a patient was included in incidence rates. All cases were physician-adjudicated. Incidence rates (during July 93-June 94 and calendar years 1999, 2005, and 2010) were calculated using the age-, race-, and sex-specific number of TIAs divided by the GCNKSS population in that group; rates were standardized to the 2010 U.S.

Population: t Tests with Bonferroni correction were used to compare rates over time.

Results: There were a total of 4746 TIA events; 53% were female, and 12% were black. In males, incidence decreased from 153 (95% confidence interval [CI] 139-167) per 100,000 in 1993/4 to 117 (95% CI 107-128) in 2010 (P < .05 for trend test) but was similar over time among females (107 (95% CI 97-116) to 102 (95%CI 94-111), P > .05).

Conclusions: Within the GCNKSS population, TIA incidence decreased significantly over time in males but not females, data which parallels trends in ischemic stroke in the GCNKSS over the same time period. Future research is needed to determine if these sex differences in incidence over time continue past 2010.

Keywords: Sex-specific—incidence—transient ischemic attack—stroke.

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References

1. Madsen TE, Khoury J, Alwell K, et al. Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study. Neurology. 2017;89:990–996. - PMC - PubMed
1. Koton S, Schneider ALC, Rosamond WD, et al. STroke incidence and mortality trends in us communities, 1987 to 2011. JAMA. 2014;312:259–268. - PubMed
1. Giroud MM, Delpont B, Daubail B, et al. Temporal Trends in Sex Differences with Regard to Stroke Incidence: The Dijon Stroke Registry (1987-2012). Stroke. 2017;48:846–849. - PubMed
1. Carandang R, Seshadri S, Beiser A, et al. Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA. 2006;296:2939–46. - PubMed
1. Madsen T, Howard V, Jimenez M, et al. Impact of Conventional Stroke Risk Factors on Stroke in Women: An Update. Stroke. 2018; 49:536–542. - PMC - PubMed

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[1] Madsen TE, Khoury J, Alwell K, et al. Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study. Neurology. 2017;89:990–996. - PMC - PubMed

[2] Madsen TE, Khoury J, Alwell K, et al. Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study. Neurology. 2017;89:990–996. - PMC - PubMed

[3] Koton S, Schneider ALC, Rosamond WD, et al. STroke incidence and mortality trends in us communities, 1987 to 2011. JAMA. 2014;312:259–268. - PubMed

[4] Koton S, Schneider ALC, Rosamond WD, et al. STroke incidence and mortality trends in us communities, 1987 to 2011. JAMA. 2014;312:259–268. - PubMed

[5] Giroud MM, Delpont B, Daubail B, et al. Temporal Trends in Sex Differences with Regard to Stroke Incidence: The Dijon Stroke Registry (1987-2012). Stroke. 2017;48:846–849. - PubMed

[6] Giroud MM, Delpont B, Daubail B, et al. Temporal Trends in Sex Differences with Regard to Stroke Incidence: The Dijon Stroke Registry (1987-2012). Stroke. 2017;48:846–849. - PubMed

[7] Carandang R, Seshadri S, Beiser A, et al. Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA. 2006;296:2939–46. - PubMed

[8] Carandang R, Seshadri S, Beiser A, et al. Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA. 2006;296:2939–46. - PubMed

[9] Madsen T, Howard V, Jimenez M, et al. Impact of Conventional Stroke Risk Factors on Stroke in Women: An Update. Stroke. 2018; 49:536–542. - PMC - PubMed

[10] Madsen T, Howard V, Jimenez M, et al. Impact of Conventional Stroke Risk Factors on Stroke in Women: An Update. Stroke. 2018; 49:536–542. - PMC - PubMed

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Temporal Trends of Sex Differences in Transient Ischemic Attack Incidence Within a Population

Affiliations

Temporal Trends of Sex Differences in Transient Ischemic Attack Incidence Within a Population

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