Five-year mortality after transient ischemic attack focus on cardiometabolic comorbidity and hospital readmission

Background and Purpose-We aimed at providing estimates of mortality associated with cardiometabolic comorbidity and incident readmission from cardiometabolic as compared with noncardiometabolic conditions after a frst transient ischemic attack. Methods-Between 2000 and 2015, patients hospitalized for a frst transient ischemic attack were examined for cardiometabolic comorbidities (diabetes mellitus, coronary artery disease, heart failure, and atrial fbrillation), 5-year incident hospitalization, and time to death. Results-Of 251 patients with transient ischemic attack, 134 (53%) had at least 1 and 55 (22%) had at least 2 cardiometabolic conditions. By 5 years, 491 readmissions (134 [27%] cardiometabolic and 357 [73%] noncardiometabolic) and 75 deaths (27 [36%] cardiometabolic and 47 [64%] noncardiometabolic) were observed. Mortality was increased with any concurrent cardiometabolic comorbidity (hazard ratio, 1.89; 95% confdence interval, 1.17-3.03; P=0.0089) with multiplicative mortality risk from a combination of coronary artery disease and heart failure. Each hospitalization was associated with a 1.5-fold risk of death (95% confdence interval, 1.37-1.64; P<0.0001). Risk of cardiometabolic and noncardiometabolic mortality was correlated with the corresponding category-specifc readmission. Conclusions-Among patients hospitalized for frst transient ischemic attack, 5-year mortality is associated with concurrent cardiometabolic comorbidity and rates of subsequent hospitalization.