Undetected Mini-Strokes Threaten Thousands_ Warns Heart and Stroke by housework


									Heart and Stroke Foundation

           Undetected Mini-Strokes Threaten Thousands,
               Warns Heart and Stroke Foundation
 EMBARGOED UNTIL: TUESDAY, JUNE 8, 2004                     4 pm eastern

         The Heart and Stroke Foundation warns that untreated transient ischemic attacks (TIAs) are
 putting nearly 21,000 Canadians at increased risk of death, stroke or heart attack. Yet there is
 evidence that only a minority of TIA patients receive appropriate medical follow-up, according to a
 new study published today in the journal Neurology.

         Heart and Stroke Foundation spokesperson Dr. Alastair Buchan says, “This study and other
 recent evidence shows TIA should be treated every bit as urgently as chest pain and angina are in
 the prevention of heart attacks. Between 10 to 20% of patients with TIA will have a stroke within the
 next three months.”

        “We must make sure the public and medical professionals do not dismiss TIAs, but recognize
 them for what they are – a medical emergency and a precursor of stroke,” says Dr. Buchan, a

        Most strokes are caused by a blood clot interrupting the flow of blood to the brain. This
 produces symptoms such as weakness, paralysis or numbness, in the face, arm or leg, trouble
 speaking or understanding speech, confusion, vision problems, sudden severe, unusual headache
 and dizziness. The symptoms of a TIA are similar but tend to go away quickly.

         “Because the symptoms of a mini-stoke or TIA can go away in a few minutes or hours, people
 don’t realize just how serious they are,” says Dr. Michael Hill, Heart and Stroke Foundation
 researcher and the study’s lead author. “TIAs are under-recognized, under-estimated and under-
 treated. As a result, we’re losing the opportunity to prevent thousands of strokes.”

          Applying the rates observed in the study, there may be at least 21,000 TIAs each year in
 Canada. Many people with TIA fail to report their experience to their doctor or go to the hospital. “All
 patients with TIA require urgent evaluation; approximately 20% may require admission to prevent
 stroke,” says Dr. Hill, who is Director of the Stroke Unit at the Foothills Medical Centre. “The tragedy
 is that less than 50% of patients are seen urgently, either because they don’t recognize their
 symptoms as important, or because acute medical services are not available to them.”

         Prompt, appropriate treatment of TIA could reduce the risk of stroke and death for these
 patients, says the Heart and Stroke Foundation. A recent study published in March in the Canadian
 Medical Association Journal indicated that many TIA patients in Ontario did not receive adequate
 diagnostic testing or follow-up treatment – but new information indicates some dramatic changes.

Heart and Stroke Foundation

          Using data from the Ontario Stroke Registry (May – December 2000), a computerized
 database established by the Heart and Stroke Foundation as part of the Coordinated Stroke Strategy,
 investigators studied 371 TIA and 418 ischemic stroke patients diagnosed in the emergency
 departments of four regional stroke centres. The study found that compared with stroke patients,
 those experiencing a TIA were significantly less likely to have diagnostic CT or MRI testing, to be
 examined by a neurologist, or to be discharged with clot-preventing medication.

              Percent who:                                                                  TIA       Stroke
                                                                                          Patients   Patients
              Have CT or MRI neuroimaging in the emergency                                 43%         96%
              Are examined in the hospital by a neurologist*                               29%        69%
              Are discharged with medication to reduce the risk of                         63%        80%
              blood clots (antithrombotics)*
            Source: HSF’s Ontario Stroke Strategy, December 2000
             * Difference between the two groups is statistically significant (p<0.001)

 New Strategy, Dramatic Change
         That was the picture in 2000, but recent dramatic changes to these figures are encouraging.
 “A coordinated stroke strategy makes a huge difference in the way TIAs are treated,” says Dr. Frank
 Silver, Heart and Stroke Foundation spokesperson, and Co-Principal Investigator for the Registry of
 the Canadian Stroke Network.

        Latest figures show that in 20031, 78% of TIA patients arriving at regional stroke centres in
 Ontario received CT or MRI neuroimaging in the emergency department, up from 43% in 2000. The
 percent discharged with medication to reduce the risk of blood clot also increased significantly, from
 63% in 2000 to 79% in 2003.

         “With strong support from the Ministry of Health and Long Term Care and the Heart and
 Stroke Foundation, Ontario’s Coordinated Stroke Network has already demonstrated impressive
 improvements in stroke care in this province,” says Dr. Silver.

        “Clearly these changes show that organized stroke care can have a dramatic impact on
 treatment and care in a relatively short period,” says Dr. Alastair Buchan. Other provinces are also
 recognizing the value of coordinated stroke strategies – in their latest budget, the government of
 Nova Scotia announced funding to further the work of their provincial Stroke Strategy Committee.

        The Heart and Stroke Foundation, the Canadian Stroke Network and other partner
 organizations are building on these experiences to develop a national stroke strategy that will support
 the development of coordinated stroke strategies in all provinces, so that all Canadians can benefit
 from improved stroke care.

         The Foundation is also leading efforts across the country to increase Canadians’ awareness
 of the signs of TIA and stroke. “It is vitally important that the public and health professionals
 understand the importance of recognizing and treating TIAs,” says Dr. Buchan.

            Source of the data was the Registry of the Canadian Stroke Network and represent 653 TIA and 1,159 ischemic
        stroke patients diagnosed at Ontario Regional Stroke Centres between July to December, 2003.
Heart and Stroke Foundation

        The Foundation is supporting the search for effective treatment of TIAs by funding Dr.
 Buchan’s leadership of the FASTER trial, a multi-centre study comparing different therapies to
 prevent stroke in those who have experienced a TIA or mild stroke.

          The Heart and Stroke Foundation provides a number of health information resources,
 including a national televised PSA campaign, the new Understanding Transient Ischemic Attack (TIA)
 workbook (sponsored by Sanofi-Synthélabo), an online Heart and Stroke Risk Assessment and a
 Blood Pressure Action Plan. Additional resources are available through www.heartandstroke.ca or by
 calling the Foundation’s toll-free number 1-888-HSF-INFO (1-888-473-4636).

        June is Stroke Awareness Month in Canada.


 For more information, contact:

 Heather Rourke
 Heart and Stroke Foundation of Canada
 613-569-4361, ext 318

 Elissa Freeman/Sharon Edwards
 Heart and Stroke Foundation of Ontario
 416-489-7111, ext 316 or 455

 For your local media contact, please see “contact us” at www.heartandstroke.ca/media

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