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Duration of symptom and ABCD2 score as predictors of risk of early recurrent events after transient ischemic attack: a hospital-based case series study.

Li Q, Zhu X, Feng C, Fang M, Liu X - Med. Sci. Monit. (2015)

Bottom Line: Hypertension, dyslipidemia, a history of ischemic stroke or TIA, and ABCD2 score were significantly associated with the recurrent events after TIA (P<0.001, P=0.02, P<0.001, P=0.02).Hypertension (RR=9.21; 95% CI, 3.07-27.61, P<0.001) and duration of symptom (RR=1.10; 95% CI, 1.02-1.17, P=0.01) as an item of ABCD2 score were highly predictive of the severity of recurrent events, whereas ABCD2 score as a whole (P=0.18) proved to be less strongly predictive.A history of hypertension and long duration of symptom independently and significantly predict severe recurrent events after TIA within 7 days, but a high ABCD2 score was less strongly predictive of severe recurrent events.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China (mainland).

ABSTRACT

Background: The aim of this study was to refine clinical risk factor stratification and make an optimal intervention plan to prevent ischemic stroke.

Material/methods: Clinical data, including diffusion-weighted imaging (DWI) findings, were collected in a cohort of hospitalized transient ischemic attack (TIA) patients from January 2010 to December 2011. Recurrent cerebrovascular events after TIA, including recurrent TIA, minor stroke, and major stroke, were identified by face-to-face follow-up. A multivariate, ordinal, logistic regression model was used to determine significant predictors of recurrent events.

Results: Of 106 TIA patients, 24 (22.6%) had recurrent TIA and 20 (18.9%) had a stroke within 7 days. Hypertension, dyslipidemia, a history of ischemic stroke or TIA, and ABCD2 score were significantly associated with the recurrent events after TIA (P<0.001, P=0.02, P<0.001, P=0.02). Hypertension (RR=9.21; 95% CI, 3.07-27.61, P<0.001) and duration of symptom (RR=1.10; 95% CI, 1.02-1.17, P=0.01) as an item of ABCD2 score were highly predictive of the severity of recurrent events, whereas ABCD2 score as a whole (P=0.18) proved to be less strongly predictive.

Conclusions: A history of hypertension and long duration of symptom independently and significantly predict severe recurrent events after TIA within 7 days, but a high ABCD2 score was less strongly predictive of severe recurrent events.

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Predictive values of different predictive equations. Compared to the first predictive equation, the second equation, which included ABCD2 score, did not show a significant improvement in predictive value for the severity of recurrent events, whereas the third equation, which included duration of symptom, significantly improved the predictive value for the severity of recurrent events. * P<0.05 vs. risk factors only.
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f1-medscimonit-21-262: Predictive values of different predictive equations. Compared to the first predictive equation, the second equation, which included ABCD2 score, did not show a significant improvement in predictive value for the severity of recurrent events, whereas the third equation, which included duration of symptom, significantly improved the predictive value for the severity of recurrent events. * P<0.05 vs. risk factors only.

Mentions: In this part, we constructed a multivariate, stepwise, logistic regression model to analyze the predictive value of duration of symptom as an item of ABCD2 score for the severity of recurrent events. “No recurrent events”, “recurrent TIA”, “minor stroke”, and “major stroke” were defined as 0, 1, 2, and 3, respectively. First, 3 variants (hypertension, dyslipidemia, and history of cerebral infarction or TIA) related to the severity of recurrent events (Table 1), together with age and sex, were included in the equation to show the severity of recurrent events (white histogram). Second, the ABCD2 score was added to the predictive equation (grey histogram). Third, duration of symptom was added to the first predictive equation (black histogram). The results showed that compared to the first predictive equation, the second equation, which included ABCD2, score did not show a significant improvement of the predictive value for the severity of recurrent events, whereas the third equation, which included duration of symptom, significantly improved the predictive value for the severity of recurrent events (χ2 47.9 vs. 34.8, P=0.01) (Figure 1).


Duration of symptom and ABCD2 score as predictors of risk of early recurrent events after transient ischemic attack: a hospital-based case series study.

Li Q, Zhu X, Feng C, Fang M, Liu X - Med. Sci. Monit. (2015)

Predictive values of different predictive equations. Compared to the first predictive equation, the second equation, which included ABCD2 score, did not show a significant improvement in predictive value for the severity of recurrent events, whereas the third equation, which included duration of symptom, significantly improved the predictive value for the severity of recurrent events. * P<0.05 vs. risk factors only.
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4310715&req=5

f1-medscimonit-21-262: Predictive values of different predictive equations. Compared to the first predictive equation, the second equation, which included ABCD2 score, did not show a significant improvement in predictive value for the severity of recurrent events, whereas the third equation, which included duration of symptom, significantly improved the predictive value for the severity of recurrent events. * P<0.05 vs. risk factors only.
Mentions: In this part, we constructed a multivariate, stepwise, logistic regression model to analyze the predictive value of duration of symptom as an item of ABCD2 score for the severity of recurrent events. “No recurrent events”, “recurrent TIA”, “minor stroke”, and “major stroke” were defined as 0, 1, 2, and 3, respectively. First, 3 variants (hypertension, dyslipidemia, and history of cerebral infarction or TIA) related to the severity of recurrent events (Table 1), together with age and sex, were included in the equation to show the severity of recurrent events (white histogram). Second, the ABCD2 score was added to the predictive equation (grey histogram). Third, duration of symptom was added to the first predictive equation (black histogram). The results showed that compared to the first predictive equation, the second equation, which included ABCD2, score did not show a significant improvement of the predictive value for the severity of recurrent events, whereas the third equation, which included duration of symptom, significantly improved the predictive value for the severity of recurrent events (χ2 47.9 vs. 34.8, P=0.01) (Figure 1).

Bottom Line: Hypertension, dyslipidemia, a history of ischemic stroke or TIA, and ABCD2 score were significantly associated with the recurrent events after TIA (P<0.001, P=0.02, P<0.001, P=0.02).Hypertension (RR=9.21; 95% CI, 3.07-27.61, P<0.001) and duration of symptom (RR=1.10; 95% CI, 1.02-1.17, P=0.01) as an item of ABCD2 score were highly predictive of the severity of recurrent events, whereas ABCD2 score as a whole (P=0.18) proved to be less strongly predictive.A history of hypertension and long duration of symptom independently and significantly predict severe recurrent events after TIA within 7 days, but a high ABCD2 score was less strongly predictive of severe recurrent events.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China (mainland).

ABSTRACT

Background: The aim of this study was to refine clinical risk factor stratification and make an optimal intervention plan to prevent ischemic stroke.

Material/methods: Clinical data, including diffusion-weighted imaging (DWI) findings, were collected in a cohort of hospitalized transient ischemic attack (TIA) patients from January 2010 to December 2011. Recurrent cerebrovascular events after TIA, including recurrent TIA, minor stroke, and major stroke, were identified by face-to-face follow-up. A multivariate, ordinal, logistic regression model was used to determine significant predictors of recurrent events.

Results: Of 106 TIA patients, 24 (22.6%) had recurrent TIA and 20 (18.9%) had a stroke within 7 days. Hypertension, dyslipidemia, a history of ischemic stroke or TIA, and ABCD2 score were significantly associated with the recurrent events after TIA (P<0.001, P=0.02, P<0.001, P=0.02). Hypertension (RR=9.21; 95% CI, 3.07-27.61, P<0.001) and duration of symptom (RR=1.10; 95% CI, 1.02-1.17, P=0.01) as an item of ABCD2 score were highly predictive of the severity of recurrent events, whereas ABCD2 score as a whole (P=0.18) proved to be less strongly predictive.

Conclusions: A history of hypertension and long duration of symptom independently and significantly predict severe recurrent events after TIA within 7 days, but a high ABCD2 score was less strongly predictive of severe recurrent events.

Show MeSH
Related in: MedlinePlus