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Open Access

Risk of ischaemic stroke in patients with transient global amnesia: a propensity-matched cohort study

Sang Hun Lee, Keon-Yeup Kim, Jeong-Woo Lee, So-Jeong Park, Jin-Man Jung
DOI: 10.1136/svn-2021-001006 Published 11 July 2022
Sang Hun Lee
1 Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
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Keon-Yeup Kim
1 Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
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Jeong-Woo Lee
2 Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, Republic of Korea
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So-Jeong Park
2 Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, Republic of Korea
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Jin-Man Jung
1 Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
3 Korea University Zebrafish Translational Medical Research Center, Ansan, Republic of Korea
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    Figure 1

    Flow chart for the selection of cases and controls based on a propensity score-matched cohort study of the National Health Insurance Service (NHIS) data. TGA, transient global amnesia.

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    Figure 2

    Standardised differences in variables included in the propensity score. Black lozenges indicate the entire study population (140 478 participants). Black dots indicate the propensity score-matched participants (20 493 participants). A-Fib, atrial fibrillation; DM, diabetes mellitus; d/o, disorder; MI, myocardial infarction.

Tables

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  • Table 1

    Baseline characteristics of the TGA cases versus age-matched and sex-matched extraction group and absolute standardised differences after propensity score matching

    Clinical valuesTGA case
    (n=10 461)
    Age-matched and sex-matched extraction group
    (n=140 486)
    Absolute standardised difference
    Before PS matchingAfter 1:2 PS matching
    (TGA, n=10 448)
    (control, n=20 442)
    Age (years)60.5±12.660.7±12.40.0180.032
    Female sex7067 (67.6)93 117 (66.3)0.0270.013
    Stroke risk factors
     Hypertension5161 (49.3)53 017 (37.7)0.236*0.018
     DM3772 (36.1)29 933 (21.3)0.331*0.025
     Hyperlipidaemia5815 (55.6)32 462 (23.1)0.705*0.014
     Cardiac disease
      A-Fib263 (2.5)1727 (1.2)0.0950.009
      MI262 (2.5)1536 (1.1)0.106*0.016
    Depressive d/o396 (3.8)1655 (1.2)0.168*0.051
    Anxiety d/o3858 (36.9)18 217 (13.0)0.575*0.045
    Seizure/epilepsy73 (0.7)528 (0.4)0.0440.005
    Migraine1908 (18.2)8397 (6.0)0.382*0.069
    Antithrombotic user8383 (80.1)67 108 (47.8)0.716*0.009
    • Results are expressed as number (%) or mean±SD. Antithrombotics include antiplatelet agents and anticoagulants.

    • *Absolute standardised difference ≥0.1.

    • A-Fib, atrial fibrillation; DM, diabetes mellitus; d/o, disorder; MI, myocardial infarction; PS, propensity score; TGA, transient global amnesia.

  • Table 2

    Multivariable analysis of outcomes among TGA participants versus propensity score-matched control participants

    VariablesCrude HR (95% CI)P valueAdjusted HR (95% CI)*P value
    Ischaemic stroke0.916 (0.846 to 0.992)0.0321.194 (1.043 to 1.368)0.010
    Haemorrhagic stroke 
     SAH0.993 (0.720 to 1.370)0.9671.104 (0.665 to 1.832)0.702
     ICH0.943 (0.764 to 1.163)0.5810.845 (0.606 to 1.177)0.319
     SDH1.684 (1.172 to 2.421)0.0051.849 (0.997 to 3.430)0.051
    All-type stroke0.945 (0.878 to 1.018)0.1401.197 (1.056 to 1.357)0.005
    • Total number of propensity score-matched participants, n=150 947 (10 461 patients with TGA and 140 486 control participants). Multivariable Cox regression analysis was used to examine the diagnoses of TGA and all-type stroke including ICH, SDH, SAH and ischaemic stroke.

    • *Adjusted for enrolment year.

    • ICH, intracerebral haemorrhage; SAH, subarachnoid haemorrhage; SDH, subdural haematoma; TGA, transient global amnesia.

  • Table 3

    Multivariable Cox regression analysis for ischaemic stroke and all types of stroke among TGA participants

    Clinical valuesIschaemic strokeAll-type stroke
    Crude HRP valueAdjusted HR*P valueCrude HRP valueAdjusted HR*P value
    Hypertension0.381 (0.319 to 0.455)<0.0011.545 (1.266 to 1.885)<0.0010.415 (0.353 to 0.478)<0.0011.446 (1.206 to 1.732)<0.001
    DM0.514 (0.438 to 0.603)<0.0011.321 (1.116 to 1.565)0.0010.549 (0.473 to 0.637)<0.0011.252 (1.070 to 1.464)0.005
    Hyperlipidaemia0.757 (0.642 to 0.892)<0.0010.994 (0.790 to 1.128)0.5270.756 (0.649 to 0.880)<0.0010.963 (0.817 to 1.135)0.654
    A-Fib0.370 (0.265 to 0.517)<0.0011.564 (1.106 to 2.213)0.0110.376 (0.275 to 0.515)<0.0011.600 (1.156 to 2.215)0.004
    MI0.667 (0.435 to 1.022)0.0630.881 (0.569 to 1.365)0.5710.681 (0.456 to 1.018)0.0610.890 (0.591 to 1.340)0.575
    Depressive d/o0.690 (0.480 to 0.990)0.0441.234 (0.852 to 1.789)0.2660.711 (0.505 to 1.000)0.0501.206 (0.851 to 1.709)0.292
    Anxiety d/o0.822 (0.698 to 0.967)0.0180.999 (0.843 to 1.184)0.9910.805 (0.693 to 0.936)0.0051.039 (0.887 to 1.216)0.639
    Seizure/epilepsy0.724 (0.329 to 1.595)0.4231.433 (0.656 to 3.130)0.3670.615 (0.306 to 1.236)0.1721.687 (0.858 to 3.315)0.129
    Migraine0.861 (0.705 to 1.051)0.1421.102 (0.899 to 1.352)0.3500.900 (0.746 to 1.086)0.2731.049 (0.866 to 1.270)0.628
    Antithrombotic user2.215 (1.703 to 2.881)<0.0011.048 (0.789 to 1.393)0.7452.194 (1.721 to 2.796)<0.0011.108 (0.853 to 1.438)0.443
    • *Adjusted for age, sex and all other comorbidities.

    • A-fib, atrial fibrillation; DM, diabetes mellitus; d/o, disorder; MI, myocardial infarction; TGA, transient global amnesia.

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Risk of ischaemic stroke in patients with transient global amnesia: a propensity-matched cohort study
Sang Hun Lee, Keon-Yeup Kim, Jeong-Woo Lee, So-Jeong Park, Jin-Man Jung
Stroke and Vascular Neurology Apr 2022, 7 (2) e001006; DOI: 10.1136/svn-2021-001006

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Risk of ischaemic stroke in patients with transient global amnesia: a propensity-matched cohort study
Sang Hun Lee, Keon-Yeup Kim, Jeong-Woo Lee, So-Jeong Park, Jin-Man Jung
Stroke and Vascular Neurology Apr 2022, 7 (2) e001006; DOI: 10.1136/svn-2021-001006
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Risk of ischaemic stroke in patients with transient global amnesia: a propensity-matched cohort study
Sang Hun Lee, Keon-Yeup Kim, Jeong-Woo Lee, So-Jeong Park, Jin-Man Jung
Stroke and Vascular Neurology Apr 2022, 7 (2) e001006; DOI: 10.1136/svn-2021-001006
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