Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort study

<p>Abstract</p> <p>Background</p> <p>Transient ischemic attack (TIA) patients are at a high vascular risk. Recently the ABCD<sup>2 </sup>score was validated for evaluating short-term stroke risk after TIA. We assessed the value of this score to predict the v...

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Main Authors: Sander Dirk, Bockelbrink Angelina, Esposito Lorena, Sadikovic Suwad, Feurer Regina, Holzer Katrin, Hemmer Bernhard, Poppert Holger
Format: Article
Language:English
Published: BMC 2010-06-01
Series:BMC Neurology
Online Access:http://www.biomedcentral.com/1471-2377/10/50
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spelling doaj-ab1185fb93284814a5db41e56011d6cf2020-11-25T00:24:55ZengBMCBMC Neurology1471-23772010-06-011015010.1186/1471-2377-10-50Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort studySander DirkBockelbrink AngelinaEsposito LorenaSadikovic SuwadFeurer ReginaHolzer KatrinHemmer BernhardPoppert Holger<p>Abstract</p> <p>Background</p> <p>Transient ischemic attack (TIA) patients are at a high vascular risk. Recently the ABCD<sup>2 </sup>score was validated for evaluating short-term stroke risk after TIA. We assessed the value of this score to predict the vascular outcome after TIA during medium- to long-term follow-up.</p> <p>Methods</p> <p>The ABCD<sup>2 </sup>score of 176 TIA patients consecutively admitted to the Stroke Unit was retrospectively calculated and stratified into three categories. TIA was defined as an acute transient focal neurological deficit caused by vascular disease and being completely reversible within 24 hours. All patients had to undergo cerebral MRI within 5 days after onset of symptoms as well as extracranial and transcranial Doppler and duplex ultrasonography. At a median follow-up of 27 months, new vascular events were recorded. Multivariate Cox regression adjusted for EDC findings and heart failure was performed for the combined endpoint of cerebral ischemic events, cardiac ischemic events and death of vascular or unknown cause.</p> <p>Results</p> <p>Fifty-five patients (32.0%) had an ABCD<sup>2 </sup>score ≤ 3, 80 patients (46.5%) had an ABCD2 score of 4-5 points and 37 patients (21.5%) had an ABCD<sup>2 </sup>score of 6-7 points. Follow-up data were available in 173 (98.3%) patients. Twenty-two patients (13.8%) experienced an ischemic stroke or TIA; 5 (3.0%) a myocardial infarction or acute coronary syndrome; 10 (5.7%) died of vascular or unknown cause; and 5 (3.0%) patients underwent arterial revascularization. An ABCD<sup>2 </sup>score > 3 was significantly associated with the combined endpoint of cerebral or cardiovascular ischemic events, and death of vascular or unknown cause (hazard ratio (HR) 4.01, 95% confidence interval (CI) 1.21 to 13.27). After adjustment for extracranial ultrasonographic findings and heart failure, there was still a strong trend (HR 3.13, 95% CI 0.94 to 10.49). Whereas new cardiovascular ischemic events occurred in 9 (8.3%) patients with an ABCD<sup>2 </sup>score > 3, this happened in none of the 53 patients with a score ≤ 3.</p> <p>Conclusions</p> <p>An ABCD<sup>2 </sup>score > 3 is associated with an increased general risk for vascular events in the medium- to long-term follow-up after TIA.</p> http://www.biomedcentral.com/1471-2377/10/50
collection DOAJ
language English
format Article
sources DOAJ
author Sander Dirk
Bockelbrink Angelina
Esposito Lorena
Sadikovic Suwad
Feurer Regina
Holzer Katrin
Hemmer Bernhard
Poppert Holger
spellingShingle Sander Dirk
Bockelbrink Angelina
Esposito Lorena
Sadikovic Suwad
Feurer Regina
Holzer Katrin
Hemmer Bernhard
Poppert Holger
Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort study
BMC Neurology
author_facet Sander Dirk
Bockelbrink Angelina
Esposito Lorena
Sadikovic Suwad
Feurer Regina
Holzer Katrin
Hemmer Bernhard
Poppert Holger
author_sort Sander Dirk
title Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort study
title_short Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort study
title_full Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort study
title_fullStr Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort study
title_full_unstemmed Prognostic value of the ABCD<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (TIA) - a cohort study
title_sort prognostic value of the abcd<sup>2 </sup>score beyond short-term follow-up after transient ischemic attack (tia) - a cohort study
publisher BMC
series BMC Neurology
issn 1471-2377
publishDate 2010-06-01
description <p>Abstract</p> <p>Background</p> <p>Transient ischemic attack (TIA) patients are at a high vascular risk. Recently the ABCD<sup>2 </sup>score was validated for evaluating short-term stroke risk after TIA. We assessed the value of this score to predict the vascular outcome after TIA during medium- to long-term follow-up.</p> <p>Methods</p> <p>The ABCD<sup>2 </sup>score of 176 TIA patients consecutively admitted to the Stroke Unit was retrospectively calculated and stratified into three categories. TIA was defined as an acute transient focal neurological deficit caused by vascular disease and being completely reversible within 24 hours. All patients had to undergo cerebral MRI within 5 days after onset of symptoms as well as extracranial and transcranial Doppler and duplex ultrasonography. At a median follow-up of 27 months, new vascular events were recorded. Multivariate Cox regression adjusted for EDC findings and heart failure was performed for the combined endpoint of cerebral ischemic events, cardiac ischemic events and death of vascular or unknown cause.</p> <p>Results</p> <p>Fifty-five patients (32.0%) had an ABCD<sup>2 </sup>score ≤ 3, 80 patients (46.5%) had an ABCD2 score of 4-5 points and 37 patients (21.5%) had an ABCD<sup>2 </sup>score of 6-7 points. Follow-up data were available in 173 (98.3%) patients. Twenty-two patients (13.8%) experienced an ischemic stroke or TIA; 5 (3.0%) a myocardial infarction or acute coronary syndrome; 10 (5.7%) died of vascular or unknown cause; and 5 (3.0%) patients underwent arterial revascularization. An ABCD<sup>2 </sup>score > 3 was significantly associated with the combined endpoint of cerebral or cardiovascular ischemic events, and death of vascular or unknown cause (hazard ratio (HR) 4.01, 95% confidence interval (CI) 1.21 to 13.27). After adjustment for extracranial ultrasonographic findings and heart failure, there was still a strong trend (HR 3.13, 95% CI 0.94 to 10.49). Whereas new cardiovascular ischemic events occurred in 9 (8.3%) patients with an ABCD<sup>2 </sup>score > 3, this happened in none of the 53 patients with a score ≤ 3.</p> <p>Conclusions</p> <p>An ABCD<sup>2 </sup>score > 3 is associated with an increased general risk for vascular events in the medium- to long-term follow-up after TIA.</p>
url http://www.biomedcentral.com/1471-2377/10/50
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