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Patients with transient ischemic attack should be considered to have unstable angina of the brain and require urgent attention, according to a new study published in The Lancet Neurology. Prompt neurological evaluation and treatment improves outcomes and decreases overall healthcare costs, according to the EXPRESS (Early use of eXisting PREventive Strategies for Stroke) study.

In the first phase, the British researchers found 310 patients who were referred to a specialty clinic by their primary care physicians within several days of the acute event, with a median time to treatment being 19 days. In the second phase, 281 patients who were sent directly to a specialty clinic received treatment the same day.

The rate of hospital admission for recurrent stroke within 90 days was significantly lower in the second phase than in the first phase — 2% vs. 8%. Hospital stays were shorter, yielding an average per patient savings of about $900. The incidence of fatal or disabling stroke at six-month follow-up was significantly lower in the second phase than in the first phase — 0.3% vs. 5.1%.

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