Imaging Parameters Predict Recurrence After Transient Ischemic Attack or Minor Stroke Stratified by ABCD
2
Score
Author:
Jing Jing123ORCID, Suo Yue12ORCID, Wang Anxin12, Zuo Yingting12, Jiang Yong12, Liu Liping12ORCID, Zhao Xingquan12ORCID, Wang Yilong12ORCID, Li Zixiao12ORCID, Li Hao12, Meng Xia12, Wang Yongjun12ORCID, Li Jilai, Wu Jian, Zhang Mei, He Maolin, Gong Tao, Ouyang Quping, Huang Guang, Yu Fengchun, Wang Chenlong, Zhang Jinli, Wu Wenqing, Wang Yi, Yu Yaoyu, Zhang Meiyun, An Zhongping, Liu Junyan, Shi Wanying, Lu Baoquan, Geng Lijun, Wang Shujuan, Zhang Xu, Liu Ruifang, Zhao Fengli, Lin Jie, Liu Xinping, Sun Xuebing, Li Tianyuan, Wang Youming, He Xinxia, Yuan Weiqiang, Dou Ronghua, Liu Lihai, Wang Yanling, Zhang Junling, Du Haisong, Wei Yuqing, Wang Cunrui, Wang Limin, Zou Yu’an, Chen Xiaofei, Hu Fengyun, Liu Jinfeng, Zhao Lili, He Fanping, Wang Xingchen, Zhao Qingwei, Li Xiaohong, Zhao Jun, Xia Zhangyong, Li Hongjin, Yan Mingzong, Zhang Guiru, Liang Hui, Liu Yunlin, Xu Jun, Wang Runqing, Han Yuhui, Meng Xianghong, Li Mingzhen, Wang Ting, Han Xinsheng, Zhang Hongtian, Ma Congmin, Xue Wenjun, Wang Chun, Fang Yan, Liu Gexia, Wang Jianfeng, Ma Qiang, Li Xiaohong, Zheng Wenxu, Chi Haitao, Gao Lianbo, Zhou Jin, Chen Huisheng, Feng Juan, Xiao Hongbo, Xiao Lijun, Yang Yi, Li Guozhong, Zhu Yulan, Wang Lihua, Yang Yindong, Qiu Xuerong, Gong Xuhai, Chen Guohua, Peng Xiaoxiang, Liu Qunhui, Gong Shiping, Zhou Hongbin, Li Haipeng, You Yong, Lin Jinsheng, Xu Yun, Sheng Lei, Zhao Heqing, Zhuang Aixia, Ke Kaifu, Fang Qi, Dong Zhengxie, Cui Guiyun, Geng Deqin, Rong Liangqun, Shi Junfeng, Yu Ming, Xu Jun, Geng Yu, Luo Benyan, Cai Xueli, Zhou Jun, Wu Yi, Tang Weiguo, Wang Zhimin, Chen Yangmei, Wang Yanjiang, Chen Kangning, Wu Shizheng, Bu Wenguang, Cheng Xiaohua, Lu Zhengqi, Xu An’ding, Yin Jia, Cai Jifu, Guo Yi, Wu Jun, Li Lvli, Pan Li, Wang Yinzhou, Wang Ning, Niu Jianping, Li Qing, Wang Hong, Li Hongyan, Zhang Xiaoying, Zhan Liping, Chen Yongming, Wang Baojun, Wu Li’e, Liu Li, Zhao Yanru, Wu Yingchun, Zhu Runxiu, Du Yanhui, Wen Yongxia, Tian Ye, Wu Songdi, Qu Yongcai, Wu Yuncheng, Liu Jianren, Dong Qiang, Bai Qingke, Zhao Yuwu, Chen Xu, He Chaoming, Ren Lijie, Qiu Weiwen, Yao Shufang, Sun Xuwen, Zhang Hainan, Li Weirong, Gao Ligong, Chen Xianglin, Li Jianhua, Shi Qiuyan, Wang Yan, Zhao Mingzhi, Zeng Jinsheng, Wang Liping, Wang Wei, Qiu Feng, Li Zhaochen, Zhao Liang, Chen Tianbao, Xia Lei, Yang SuYun, Han Yazhou, Liu Liyan, Wu Xinxiao, Jiang Beihai, Li Lizhong, Lou Weidong, Shen Xiaoqian, Zhang Ping, Lan Weiming, Zheng Aihu, Bai Qifu, Luan Lifang, Chen Lin, Yan Liqing, Wang Yanxia, Huang Xuerong, Chai Xiangting, Liu Yanshu, You Liangjun, Yang Hongqin, Li Dongfang, Wang Huijuan, Gui Linying, Wu Aisheng, Zhang Jianling, Wang Dengling, Zhang Qinghua, He Yunhong, Guo Ruiyou, Teng Jijun, Lou Ping
Affiliation:
1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (J.J., Y.S., A.W., Y.Z., Y.J., L.L., X.Z., Yilong Wang, Z.L., H.L., X.M., Yongjun Wang). 2. China National Clinical Research Center for Neurological Diseases, Beijing, China (J.J., Y.S., A.W., Y.Z., Y.J., L.L., X.Z., Yilong Wang, Z.L., H.L., X.M., Yongjun Wang). 3. Tiantan Neuroimaging Center of Excellence, Beijing, China (J.J.).
Abstract
Background and Purpose:
Whether imaging parameters would independently predict stroke recurrence in low-risk minor ischemic stroke (MIS) or transient ischemic attack (TIA) according to traditional score system (such as ABCD
2
score, which was termed on the basis of the initials of the five factors: age, blood pressure, clinical features, duration, diabetes) remains unclear. We sought to evaluate the association between imaging parameters and 1-year stroke recurrence in patients with TIA or MIS in different risk stratum stratified by ABCD
2
score.
Methods:
We included patients with TIA and MIS (National Institutes of Health Stroke Scale score ≤3) with complete baseline vessel and brain imaging data from the Third China National Stroke Registry III. Patients were categorized into different risk groups based on ABCD
2
score (low risk, 0–3; moderate risk, 4–5; and high risk, 6–7). The primary outcome was stroke recurrence within 1 year. Multivariable Cox proportional-hazards regression models were used to assess whether imaging parameters (large artery stenosis, infarction number) were independently associated with stroke recurrence.
Results:
Of the 7140 patients included, 584 patients experienced stroke recurrence within 1 year. According to the ABCD
2
score, large artery stenosis was associated with higher stroke recurrence in both low-risk (adjusted hazard ratio, 1.746 [95% CI, 1.200–2.540]) and moderate-risk group (adjusted hazard ratio, 1.326 [95% CI, 1.042–1.687]) but not in the high-risk group (
P
>0.05). Patients with multiple acute infarctions or single acute infarction had a higher risk of recurrent stroke than those with no infarction in both low- and moderate-risk groups, but not in the high-risk group.
Conclusions:
Large artery stenosis and infarction number were independent predictors of 1-year stroke recurrence in low-moderate risk but not in high-risk patients with TIA or MIS stratified by ABCD
2
score. This finding emphasizes the importance of early brain and vascular imaging evaluation for risk stratification in patients with TIA or MIS.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)
Cited by
18 articles.
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