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Addition Criminal Artery Stenosis to ABCD2Score to Identify Patients at Early Stroke Risk after Transient Ischemic Attack

Author: ChengZhengPing
Tutor: WuJie
School: Jilin University
Course: Clinical
Keywords: Transient ischemic attack cerebral infarction ABCD2score criminalartery stenosis
CLC: R743.31
Type: Master's thesis
Year: 2012
Downloads: 69
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Background Transient ischemic attack (TIA) is one of the mainprecursors of cerebral infarction, with third of the TIA patients developing tocerebral infarction. According to the high stroke rate after TIA, it’s veryimportant to provide clinic assessment timely and accurately. Since the21stcentury, California score, ABCD score and ABCD2score have been developedwith the purpose of predicting short-term risk of stroke after TIA. ABCD2scoring system have been extensively used in recent years, however, duing tolack of imaging in this scoring system, it needs to be further improvement. Inthis study, we added criminal artery stenosis to ABCD2score to identifypatients at early stroke risk after transient ischemic attack.Materials and Methods From Sept.2010to Apri.2012,99hospitalizedTIA patients were involved in the study, which were collected All patients werescanned with brain magnetic resonance imaging (including DWI), and CTAexamination in evaluating brain infarction. According to the criminal arterystenosis rate, the patients were divided into two groups:<50%group and≥50%group. According to the scoring system of ABCD2combined withcriminal artery stenosis, the patients were separated into low risk group, midrisk group and high risk group. The incidence of stroke within7days afteronset of TIA were assessed and compared predictive value among the fourscoring systems. The risk factors of stroke after TIA were evaluated by logisticregression mode1.Result9.30%patients had a stroke within7days in low risk group (score0-3),29.79%had a stroke in mid risk group(score4-6), and66.67%in highrisk group(score7-9).The incidence of cerebral infarction was higher in high risk group compared with other two groups within7days after TIA (P<0.01).By contrast, the mid risk group remained associated with an increased risk ofstroke, although there was no significant difference in stroke within7days afterTIA between low risk group and mid risk group (P>0.05). Logistic regressionmodels showed that: patients with criminal artery stenosis≥50%werepredicted stroke risk within7days(OR=3.565,95%CI1.397~9.098, P<0.01),unilateral weakness (OR=4.560,95%CI1.552~13.401, P<0.01). By contrast, inpredicting the early risk with other factors after TIA, althouth there was nostatistically significance (P>0.05), there was associated with an increased riskof stroke.The stroke risk after TIA in7days were predicted: the area under thecurve of the scoring system of ABCD2combined with criminal artery stenosis,ABCD2score,ABCD score and California score were0.728,0.683,0.665,0.634.Conclusions The incidence of cerebral infarction within7days after TIAwere higher in high risk group compared with other two groups. The criminalartery stenosis≥50%and unilateral weakness were independent stroke riskfactors after TIA.The assessment value of the scoring system of ABCD2combined with criminal artery stenosis is evidently superior to others.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke) > Transient ischemic
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