Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Validation of the Canadian TIA Score to Predict Subsequent Stroke Risk in Chinese TIA Patients
First author：Chengyuan Yang
Corresponding author：Xia Meng,Jie Xu
essential_information
- Person in charge：Chengyuan Yang
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20210060
- Published time：2022-05-05
2022-05-05
Published articles
Journal：Cerebrovascular disease
Publication type: Original Contributions
IF(IF): 3.104
PMID: 35512630 Link To Pubmed Full text Download
Background And Purpose
The recently derived Canadian TIA score performed significantly better predictive effectiveness than the traditional ABCD2 score and was more convenient for clinical application than several variations of ABCD2 score including neuroimaging. However, it still needs external verification of other races to prove the predictive power of Canadian TIA score. Moreover, the Canadian TIA score might have chance to be further simplified and identify specific cut-offs for changes of interventions after TIA onset. Therefore, we aimed to verify and modify the Canadian TIA Score optimised for prevention of subsequent stroke risk after TIA.
Method
The Third China National Stroke Registry (CNSR-III) was a nationwide, multicenter prospective registry recruiting consecutive patients with acute ischemic stroke or TIA within 7 days of the onset from August 2015 to March 2018. The Canadian TIA Score was verified in patients diag- nosed with TIA from the CNSR-III (N = 1,184). The outcomes were subsequent stroke at 7 days, 14 days/discharge, 3 months, and 1 year. Outcomes were recorded by face-to- face assessment or telephone interview. The prognostic per- formance of the scoring system was assessed by the area under the receiver operator characteristic curve (AUC).
Conclusion
The Cana- dian TIA Score might be a better prognostic score than the ABCD2 score for post-TIA stroke risk, especially in patients with atypical TIA.
Main results
Of 1,184 TIA patients (mean [IQR] age, 61.00 [53.00– 69.00] years; 413 women [34.88%]), there were 40 patients (3.38%) having subsequent stroke within 7 days, 45 (3·80%) within 14 days/hospitalization, 66 (5·57%) within 3 months, and 100 (8·45%) within 1 year. The Canadian TIA Score (AUC 0 63–0·68) seemed to be a better prognostic score of stroke risk than the ABCD2 score (AUC 0·61–0·62), although no sig- nificant differences were noted. In the subgroup of atypical TIA, the Canadian TIA Score showed significantly stronger predictivity than the ABCD2 score within 7 days (0.80 [0.62– 0.98] vs. 0.52 [0.30–0.73]; difference in AUC, 0.28 [0.03–0.53]; p, 0.026), and marginal significantly stronger predictivity within 1 year (0.71 [0.61–0.80] vs. 0.58 [0.48–0.68]; difference in AUC, 0.12 [−0.01 to 0.25]; p, 0.06).