Open AccessImaging Parameters Predict Recurrence After Transient Ischemic Attack or Minor Stroke Stratified by ABCD 2 Score
Author(s) -
Jing Jing,
Yue Suo,
Anxin Wang,
Yingting Zuo,
Yong Jiang,
Liping Liu,
Xingquan Zhao,
Yilong Wang,
Zixiao Li,
Hao Li,
Xia Meng,
Yongjun Wang,
Jilai Li,
Jian Wu,
Mei Zhang,
Maolin He,
Tao Gong,
Quping Ouyang,
Guang Huang,
Fengchun Yu,
Chenlong Wang,
Jinli Zhang,
Wenqing Wu,
Yi Wang,
Yaoyu Yu,
Yijun Zhang,
Zhongping An,
Junyan Liu,
Wanying Shi,
Baoquan Lu,
Lijun Geng,
Shujuan Wang,
Xu Zhang,
Ruifang Liu,
Fengli Zhao,
Jie Lin,
Xinping Liu,
Xuebing Sun,
Tianyuan Li,
Youming Wang,
Xinxia He,
Weiqiang Yuan,
Ronghua Dou,
Lihai Liu,
Yanling Wang,
Junling Zhang,
Haisong Du,
Yuqing Wei,
Cunrui Wang,
Limin Wang,
Yuan Zou,
Xiaofei Chen,
Fengyun Hu,
Jinfeng Liu,
Lili Zhao,
Fanping He,
Xingchen Wang,
Qingwei Zhao,
Xiaohong Li,
Jun Zhao,
Zhangyong Xia,
Hongjin Li,
Mingzong Yan,
Guiru Zhang,
Hui Liang,
Yunling Liu,
Jun Xu,
Runqing Wang,
Han Yuhui,
Xianghong Meng,
Mingzhen Li,
Ting Wang,
Xinsheng Han,
Hongtian Zhang,
Ma Congmin,
Wenjun Xue,
Chun Wang,
Fang Yan,
Gexia Liu,
Jianfeng Wang,
Qiang Ma,
Wenxu Zheng,
Tao Wang,
Lianbo Gao,
Jin Zhou,
Dawei Chen,
Juan Feng,
HongBo Xiao,
Lijun Xiao,
Yi Yang,
Guozhong Li,
Yulan Zhu,
Lihua Wang,
Yin-Dong Yang,
Xuerong Qiu,
Xuhai Gong,
Guohua Chen,
Xiaoxiang Peng,
Qunhui Liu,
Shiping Gong,
Hongbin Zhou,
Haipeng Li,
Yong You,
Jinsheng Lin,
Yun Xu,
Lei Sheng,
Zhao He-qing,
Aixia Zhuang,
Kaifu Ke,
Qi Fang,
Zhengxie Dong,
Guiyun Cui,
Deqin Geng,
Liangqun Rong,
Junfeng Shi,
Ming Yu,
Yu Geng,
Benyan Luo,
Xueli Cai,
Jun Zhou,
Yi Wu,
Weiguo Tang,
Zhimin Wang,
Yangmei Chen,
YanJiang Wang,
Kangning Chen,
Shizheng Wu,
Wenguang Bu,
Xiaohua Cheng,
Zhengqi Lu,
Chunxue Wang,
Jia Yin,
Jifu Cai,
Yi Guo,
Jun Wu,
LI Lv-li,
Pan Li,
Yinzhou Wang,
Ning Wang,
Jianping Niu,
Qing Li,
Hong Wang,
Hongyan Li,
Xiaoying Zhang,
Liping Zhan,
Yongming Chen,
Baojun Wang,
Li-e Wu,
Li Liu,
Yanru Zhao,
Yingchun Wu,
Runxiu Zhu,
Yanhui Du,
Yongxia Wen,
Ye Tian,
Songdi Wu,
Yongcai Qu,
YunCheng Wu,
JianRen Liu,
Qiang Dong,
Qingke Bai,
Yu-wu Zhao,
Chen Xu,
Chaoming He,
Lijie Ren,
Weiwen Qiu,
Shufang Yao,
Xuwen Sun,
Hainan Zhang,
Weirong Li,
Ligong Gao,
Xianglin Chen,
Jianhua Li,
Qiuyan Shi,
Yan Wang,
Mingzhi Zhao,
Jinsheng Zeng,
Liping Wang,
Wei Wang,
Feng Qiu,
Zhaochen Li,
Liang Zhao,
Tianbao Chen,
Lei Xia,
SuYun Yang,
Yazhou Han,
Liyan Liu,
Xinxiao Wu,
Beihai Jiang,
Lizhong Li,
Weidong Lou,
Xiaoqian Shen,
Ping Zhang,
Wei-Ming Lan,
Aihu Zheng,
Qifu Bai,
Lifang Luan,
Lin Chen,
Liqing Yan,
Yanxia Wang,
Xuerong Huang,
Xiangting Chai,
Yanshu Liu,
Liangjun You,
Hongqin Yang,
Dongfang Li,
Huijuan Wang,
Linying Gui,
Aisheng Wu,
Jianling Zhang,
Dengling Wang,
Qinghua Zhang,
Yunhong He,
Ruiyou Guo,
Jijun Teng,
Ping Lou
Publication year - 2021
Publication title -
stroke
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.397
H-Index - 319
eISSN - 1524-4628
pISSN - 0039-2499
DOI - 10.1161/strokeaha.120.032424
Subject(s) - medicine , stroke (engine) , hazard ratio , proportional hazards model , stenosis , cardiology , confidence interval , diabetes mellitus , infarction , framingham risk score , myocardial infarction , disease , mechanical engineering , engineering , endocrinology
Background and Purpose: Whether imaging parameters would independently predict stroke recurrence in low-risk minor ischemic stroke (MIS) or transient ischemic attack (TIA) according to traditional score system (such as ABCD2 score, which was termed on the basis of the initials of the five factors: age, blood pressure, clinical features, duration, diabetes) remains unclear. We sought to evaluate the association between imaging parameters and 1-year stroke recurrence in patients with TIA or MIS in different risk stratum stratified by ABCD2 score.Methods: We included patients with TIA and MIS (National Institutes of Health Stroke Scale score ≤3) with complete baseline vessel and brain imaging data from the Third China National Stroke Registry III. Patients were categorized into different risk groups based on ABCD2 score (low risk, 0–3; moderate risk, 4–5; and high risk, 6–7). The primary outcome was stroke recurrence within 1 year. Multivariable Cox proportional-hazards regression models were used to assess whether imaging parameters (large artery stenosis, infarction number) were independently associated with stroke recurrence.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.Conclusions: Large artery stenosis and infarction number were independent predictors of 1-year stroke recurrence in low-moderate 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.
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