Background: Determinants of survival and of risk of vascular events after tra nsient ischaemic attack (TIA) or minor ischaemic stroke are not well defined in the long term. We aimed to restudy these risks in a prospective cohort of patien ts after TIA or minor ischaemic stroke (Rankin grade≤ 3), after 10 years or mor e. Methods: We assessed the survival status and occurrence of vascular events in 2473 participants of the Dutch TIA Trial (recruitment in 1986- 89; arterial ca use of cerebral ischaemia). We included 24 hospitals in the Netherlands that rec ruited at least 50 patients. Primary outcomes were all- cause mortality and the composite event of death from all vascular causes, non- fatal stroke, and non - fatal myocardial infarction. We assessed cumulative risks by Kaplan- Meier a nalysis and prognostic factors with Cox univariate and multivariate analysis. Fi ndings: Follow- up was complete in 2447 (99% ) patients. After a mean follow- up of 10.1 years, 1489 (60% ) patients had died and 1336 (54% ) had had at le ast one vascular event. 10- year risk of death was 42.7% (95% CI 40.8- 44. 7). Age and sex- adjusted hazard ratios were 3.33 (2.97- 3.73) for age over 65 years, 2.10 (1.79- 2.48) for diabetes, 1.77 (1.45- 2.15) for claudication, 1. 94 (1.42- 2.65) for previous peripheral vascular surgery, and 1.50 (1.31- 1.71 ) for pathological Q waves on baseline electrocardiogram. 10- year risk of a vascular event was 44.1% (42.0- 46.1). After falling in the first 3 years, yearly risk of a vascular ev ent increased over time. Predictive factors for risk of vascular events were sim ilar to those for risk of death. Interpretation: Long- term secondary preventio n in patients with cerebral ischaemia still has room for further improvement.
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