Can a TIA (Ministroke) Shorten Your Life?

The symptoms of a transient ischemic attack (TIA) usually resolve in less than an hour, though, in some situations, the symptoms may persist for up to 24 hours. Because it’s not possible to tell the difference between a TIA and stroke symptoms, it’s vitally important to get prompt medical attention.

Even though TIA symptoms usually don’t cause long lasting complications, getting evaluated soon after your symptoms begin may help a medical team find the underlying cause of your TIA. Accurate diagnosis of your condition and treatment can go a long way toward reducing your risk of a sudden, possibly life threatening, stroke in the future.

The risk of a stroke after a TIA seems to be particularly high within the first 3 months. Roughly 20% of people who experience a TIA have a stroke within this period, and about 50% of these strokes occur within the first 2 days after a TIA.

TIA and long-term stroke risk

In a large 2021 study, researchers examined the risk of stroke after TIA by following a group of 14,059 people for almost 70 years.

Out of this large group of people, 435 experienced a TIA. The researchers matched these people with a control group of 2,175 people who didn’t develop a TIA.

The authors found that 130 people (29.5%) who had a TIA went on to have a stroke. The time period between a TIA and stroke among this group was as follows:

• 28 strokes (21.5%) occurred within 7 days
• 40 strokes (30.8%) occurred within 30 days
• 51 strokes (39.2%) occurred within 90 days
• 63 strokes (48.5%) occurred after more than 1 year

The researchers found that the risk of having a stroke was 4.37 times greater (95% confidence intervals of 3.30–5.71) in people who had a TIA than in people who didn’t.

TIA and risk of stroke death

In a 2022 study, researchers examined the outlook of 20,633 people who experienced a TIA between 1986 and 2017.

The researchers found that the risk of death was higher in all age groups among people who experienced a TIA compared with people in the same age range who didn’t have a TIA:

A variety of factors may influence your life expectancy after you have a TIA. Let’s look at these factors more closely.

Urgent assessment and treatment

Receiving a prompt medical evaluation and treatment after a TIA may significantly decrease your risk of having a future stroke.

In a 2022 study, researchers analyzed data to see if receiving prompt treatment for a TIA had long-term benefits. They determined that the 90-day stroke risk decreased by 80% when treatment started within the first 24 hours.

In the follow-up study, researchers found that stroke risk continued to be reduced even after 10 years.

Younger age of first TIA

In a 2022 study, researchers found that people who had their first TIA between the ages of 39 and 60 were at the highest risk of dying during a follow-up period of up to 30 years compared with people who had their first TIA when they were older.

Aspirin, antiplatelet, or anticoagulation medication

In the same 2022 study as above, the researchers found that people between the ages of 39 and 60 who were prescribed aspirin after a TIA had a reduced risk of stroke compared with people who weren’t prescribed any antiplatelet therapy.

Other research shows that dual antiplatelet therapy — a combination of aspirin and clopidogrel (Plavix) — provides the most benefit for some people after a TIA.

For people whose TIA may have been caused by atrial fibrillation, anticoagulation medication (blood thinner), such as Eliquis or Xarelto, is often prescribed. Blood thinners can lower the risk of a blood clot forming if the heart starts beating in an irregular rhythm in the future.

Higher BMI

People with overweight or obesity are at an increased risk of having a stroke, but there’s evidence that people with a higher body mass index (BMI) have better survival rates after a stroke or TIA at a 7-year follow-up. This contradiction is referred to as an “obesity paradox.”

According to this 2019 study, a low BMI was related to a higher risk of death in older adults in general. The researchers note that poor outcomes among people who were underweight may have been responsible for the inverse relationship between BMI and stroke survival.

It’s theorized that chronic low blood oxygen levels may play a role in explaining this relationship.

Revascularization procedures

“Revascularization” refers to a group of procedures that can restore proper blood flow to blocked arteries.

If a TIA is caused by a buildup of plaque in the carotid artery, known as “carotid artery stenosis,” blood flow to the brain can be restored with procedures such as carotid endarterectomy or carotid stenting.

Many people who experience a TIA go on to live a long life and never experience a stroke. Getting prompt medical attention and treatment can help minimize your risk of developing a future stroke.

Taking steps to reduce your risk of a stroke can also help minimize your risk of premature death.

Learn more about how to prevent strokes.

It’s possible to have multiple TIAs. TIAs can occur many years apart or within hours to days.

TIAs are called “dual TIAs” when they occur twice. TIAs are known as “crescendo TIAs” when they occur multiple times in succession.

In a 2021 study, researchers found that small blood vessel disease was more likely to be the underlying cause when someone experienced two TIAs within an hour, compared with people who had multiple TIAs within the same day or week.

Crescendo TIAs are reported in less than 5% of people who have TIAs, but they have a high risk of developing into a stroke.

Having a TIA puts you at an elevated risk of having a more severe stroke in the future, especially in the 3 months after a TIA. Getting immediate medical attention and receiving a timely diagnosis and treatment are important steps in helping to reduce your risk of a future stroke.

Many people who have a TIA go on to live a long, full life. Following a doctor’s advice, making specific lifestyle changes, and managing other health conditions such as diabetes, hypertension, or heart disease, are key steps in reducing your stroke risk and prolonging your life.