The evaluation and improvement of early stroke prediction after transient ischemic attack / 中华急诊医学杂志

ABSTRACT

Objective To explore the ability of ABCD2 score + Low density lipoprotein (LDL)(ABCD2L) in predicting early stroke risk after transient ischemic attack (TIA) . Method A total of 165TIA patients were evaluated and classified according to ABCD2 score and ABCD2L score. The occurrences of cerebral infarction were observed at 2th day or 7th day. ROC curve was used to compare the predictive vaule of two scores. Furthermore, according to these two scores, these patients were classified into three risk groups (low, moderate and high ), observed their stroke rate , and compared the differences of three groups with x2 test. Results The two-day risk of stroke was 13.33% and the seven-day risk of stroke was 20. 0% in 165 patients. When the occurrences of cerebral infarction were observed in two days, the area under the curves (AUC) of ABCD2 and ABCD2L was 0. 76 and 0. 80; observed in seven days, the AUC of two scores was 0. 73 and 0. 79. According to the risk stratification of ABCD2 score, in three risk groups,the two-day risk of stroke was 1.9%, 14. 9% and 30. 8%; the seven-day risk of stroke was 3. 8%, 21.8%and 46. 2% ( P ＜ 0. 05 ) . According to the risk stratification of ABCD2 L score, the two-day risk of stroke was 0%, 7. 8% and 31.1% ; the seven-day risk of stroke was 0%, 12. 6% and 44. 4% ( P ＜ 0. 05 ).Conclusions The predictive accuracy of the ABCD2L score is significantly higher than that of ABCD2 score. Furthermore, individuals at high early risk of stroke after TIA can be identified according to the risk stratification of ABCD2L score.