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Essen score in the prediction of cerebrovascular events compared with cardiovascular events after ischaemic stroke or transient ischaemic attack: a nationwide registry analysis.
Li, Long; Jin, Ze-Ning; Pan, Yue-Song; Jing, Jing; Meng, Xia; Jiang, Yong; Li, Hao; Guo, Cai-Xia; Wang, Yong-Jun.
Affiliation
  • Li L; Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Jin ZN; Department of Cardiology and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
  • Pan YS; Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Jing J; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Meng X; China National Clinical Research Center for Neurological Diseases, Beijing, China.
  • Jiang Y; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Li H; China National Clinical Research Center for Neurological Diseases, Beijing, China.
  • Guo CX; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Wang YJ; China National Clinical Research Center for Neurological Diseases, Beijing, China.
J Geriatr Cardiol ; 19(4): 265-275, 2022 Apr 28.
Article in En | MEDLINE | ID: mdl-35572218
BACKGROUND: The Essen risk score improves stratification of patients with acute ischemic stroke by early stroke recurrence. Recent study showed it could also predict myocardial infarction (MI). This study aimed to compare the Essen score's ability to predict cerebrovascular events with compared cardiovascular events. METHODS: We included patients with acute ischaemic stroke or transient ischaemic attack within seven days from the Third China National Stroke Registry. One-year cumulative event rates of combined vascular events (a composite of MI, stroke recurrence or vascular death) and cardiac events (a composite of MI, heart failure or cardiac death) was estimated using the Kaplan-Meier method. The predictive value of the Essen score was assessed with C-statistics. In multivariate Cox regression analyses, we assessed whether Essen score, etiological subtype and imaging parameters were associated with outcomes. RESULTS: Of 13,012 patients were included, the cumulative one-year event rates were 10.03% for combined vascular events and 0.77% for cardiac events, respectively. Compared with those with an Essen score < 3, patients with an Essen score ≥ 3 were more likely to have a subsequent combined vascular event [hazard ratio (HR) = 1.39, 95% CI: 1.24-1.55] and cardiac events (HR = 2.30, 95% CI: 1.53-3.44). The score tended to be more predictive of the risk of MI (C-statistic = 0.63, 95% CI: 0.55-0.71) and cardiac events (C-statistic = 0.62, 95% CI: 0.56-0.67) than stroke recurrence (C-statistic = 0.55, 95% CI: 0.54-0.57) and combined vascular events (C-statistic = 0.56, 95% CI: 0.54-0.57). In multivariable analysis after adjusted Essen score, patients with multiple acute infarctions or single acute infarctions and large artery atherosclerosis subtype were independently associated with an increased risk of combined vascular events. While the cardioembolism subtype was associated with an increased risk of cardiac events. CONCLUSIONS: The Essen score is potentially more suitable for risk stratification of cardiovascular events than cerebrovascular events. Moreover, future predictive tools should take brain imaging findings and cause of stroke into consideration.

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Prognostic_studies / Risk_factors_studies Language: En Journal: J Geriatr Cardiol Year: 2022 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Prognostic_studies / Risk_factors_studies Language: En Journal: J Geriatr Cardiol Year: 2022 Document type: Article Affiliation country: Country of publication: