Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Imaging Parameters Predict Recurrence After Transient Ischemic Attack or Minor Stroke Stratified by ABCD 2 Score
First author：Jing Jing,Suo Yue
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Jing Jing,Suo Yue
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20200140
- Published time：2021-05-06
2021-05-06
Published articles
Journal：Stroke
Publication type: Original Contributions
IF(IF): 7.914
PMID: 33947206 Link To Pubmed Full text Download
Background And Purpose
Imaging parameters were proved to be risk factors for stroke recurrence in patients with non-disabling ischemic cerebrovascular events (NICE), including transient ischemic attack (TIA) or minor ischemic stroke (MIS). However, it is unclear whether the prognostic value of imaging parameters is consistent in different risk stratifications by the ABCD2 score.To evaluate the association between imaging parameters and one-year stroke recurrence in patients with NICE with different risk stratification by ABCD2 score.
Method
Multivariable Cox proportional-hazards regression models (model 1: adjusted for age and sex; model 2: adjusted for all potential confound factors) were used in assessing whether imaging parameters (infarction number, large artery stenosis) were independently associated with stroke recurrence. The cumulative risk of subsequent stroke stratified by imaging markers in each risk subgroup was described by drawing Kaplan-Meier curves. A 2-sided p-value, less than 0.05, was considered of statistical significance. SAS software, version 9.4 (SAS Institute Inc) was used to perform all the statistical analyses.
Conclusion
Large artery stenosis and infarction number were independent predictors of 1-year stroke recurrence in lowmoderate risk but not in high-risk patients with TIA or MIS stratified by ABCD2 score. This finding emphasizes the importance of early brain and vascular imaging evaluation for risk stratification in patients with TIA or MIS.
Main results
Of the 7140 patients included, 584 patients experienced stroke recurrence within 1 year. According to the ABCD2 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.