国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Essen score in the prediction of cerebrovascular events compared with cardiovascular events after ischaemic stroke or transient ischaemic attack: a nationwide registry analysis

第一作者：Li Long ,Jin Zening

通讯作者：Guo Caixia,Wang Yongjun

Ischemic stroke; transient ischemic attack; Essen score; Diffusion-Weighted Imaging; cardiac events

基本信息

2022-04-28

已发表文章

发表杂志：Journal of Geriatric Cardiology

发表类型: Article

影响因子(IF): 3.189

PMID: 35572218 Pubmed原文链接 全文下载

主要研究背景及目的

The Third China National Stroke Registry (CNSR-III) is a nationwide clinical registry of ischaemic stroke or TIA in China, which is designed to establish Chinese ischaemic cerebrovascular disease etiology classification. The design and rationale of CNSR-III has been described previously, while the clinical feature and follow-up outcomes have not been reported. Here, we report the contemporary risk profile, management, 1-year outcomes and risk stratification of overall CNSR-III populations.

方法

We included patients with acute ischemic stroke or TIA within 7 days form the Third China National Stroke Registry. The cumulative event rates of outcomes were estimated using the Kaplan–Meier method. Predictive value of Essen score was assessed with C-statistics. In multivariate Cox regression analyses, we assessed whether Essen score, etiology subtype and imaging parameters were associated with outcomes.

结论

The Essen score seems to be more suitable to risk-stratify cardiovascular events than cerebrovascular events. Moreover, future predictive tools should bring brain imaging and cause of stroke into consideration.

主要结果

Of 13,012 patients included, the cumulative 1-year event rates were 10.03% for combined vascular events (a composite of myocardial infarction, stroke recurrence or vascular death) and 0.77% for cardiac events (a composite of myocardial infarction, heart failure or cardiac death). The score tended to be more predictive for the risk of myocardial infarction (C statistic, 0.63; 95% CI, 0.55-0.71) and cardiac events (C statistic, 0.62; 95% CI, 0.56-0.67) than that of 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, multiple acute infarctions or single acute infarction and large artery atherosclerosis subtype were independently associated with an increased risk of combined vascular events. While cardioembolism subtype was associated with a higher risk of cardiac events.