ABCD3 and ABCD3-I Scores Are Superior to ABCD2 Score in the Prediction of Short- and Long-Term Risks of Stroke After Transient Ischemic Attack
Several risk scores have been developed to predict the stroke risk after transient ischemic attack (TIA). However, the validation of these scores in different cohorts is still limited. The objective of this study was to elucidate whether these scores were able to predict short-term and long-term ris...
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| Veröffentlicht in: | Stroke (1970) 2014-02, Vol.45 (2), p.418-425 |
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| creator | KIYOHARA, Takuya KAMOUCHI, Masahiro KUMAI, Yasuhiro NINOMIYA, Toshiharu HATA, Jun YOSHIMURA, Sohei AGO, Tetsuro OKADA, Yasushi KITAZONO, Takanari |
| description | Several risk scores have been developed to predict the stroke risk after transient ischemic attack (TIA). However, the validation of these scores in different cohorts is still limited. The objective of this study was to elucidate whether these scores were able to predict short-term and long-term risks of stroke in patients with TIA.
From the Fukuoka Stroke Registry, 693 patients with TIA were followed up for 3 years. Multivariable-adjusted Cox proportional hazards model was used to assess the hazard ratio of risk factors for stroke. The discriminatory ability of each risk score for incident stroke was estimated by using C-statistics and continuous net reclassification improvement.
The multivariable-adjusted Cox proportional hazards model revealed that dual TIA and carotid stenosis were both significant predictors for stroke after TIA, whereas abnormal diffusion-weighted image was not. ABCD3 (C-statistics 0.61) and ABCD3-I (C-statistics 0.66) scores improved the short-term predictive ability for stroke (at 7 days) compared with the ABCD2 score (C-statistics 0.54). Addition of intracranial arterial stenosis (at 3 years, continuous net reclassification improvement 30.5%; P |
| doi_str_mv | 10.1161/strokeaha.113.003077 |
| format | Article |
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From the Fukuoka Stroke Registry, 693 patients with TIA were followed up for 3 years. Multivariable-adjusted Cox proportional hazards model was used to assess the hazard ratio of risk factors for stroke. The discriminatory ability of each risk score for incident stroke was estimated by using C-statistics and continuous net reclassification improvement.
The multivariable-adjusted Cox proportional hazards model revealed that dual TIA and carotid stenosis were both significant predictors for stroke after TIA, whereas abnormal diffusion-weighted image was not. ABCD3 (C-statistics 0.61) and ABCD3-I (C-statistics 0.66) scores improved the short-term predictive ability for stroke (at 7 days) compared with the ABCD2 score (C-statistics 0.54). Addition of intracranial arterial stenosis (at 3 years, continuous net reclassification improvement 30.5%; P<0.01) and exclusion of abnormal diffusion-weighted imaging (at 3 years, continuous net reclassification improvement 24.0%; P<0.05) further improved the predictive ability for stroke risk until 3 years after TIA.
The present study demonstrates that ABCD3 and ABCD3-I scores are superior to the ABCD2 score for the prediction of subsequent stroke in patients with TIA. Addition of neuroimaging in the ABCD3 score may enable prediction of long-term stroke risk after TIA.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/strokeaha.113.003077</identifier><identifier>PMID: 24335223</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Carotid Stenosis - complications ; Carotid Stenosis - epidemiology ; Cohort Studies ; Constriction, Pathologic ; Diffusion Magnetic Resonance Imaging ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Ischemic Attack, Transient - complications ; Ischemic Attack, Transient - epidemiology ; Japan - epidemiology ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neuroimaging ; Neurology ; Prognosis ; Proportional Hazards Models ; Registries ; Risk Assessment ; Risk Factors ; Stroke - epidemiology ; Stroke - etiology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2014-02, Vol.45 (2), p.418-425</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c449t-b268ded65c3ea703b85598d0710c277acdf11e7082ec8d336ab4149e819bbf973</citedby><cites>FETCH-LOGICAL-c449t-b268ded65c3ea703b85598d0710c277acdf11e7082ec8d336ab4149e819bbf973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28195862$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24335223$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KIYOHARA, Takuya</creatorcontrib><creatorcontrib>KAMOUCHI, Masahiro</creatorcontrib><creatorcontrib>KUMAI, Yasuhiro</creatorcontrib><creatorcontrib>NINOMIYA, Toshiharu</creatorcontrib><creatorcontrib>HATA, Jun</creatorcontrib><creatorcontrib>YOSHIMURA, Sohei</creatorcontrib><creatorcontrib>AGO, Tetsuro</creatorcontrib><creatorcontrib>OKADA, Yasushi</creatorcontrib><creatorcontrib>KITAZONO, Takanari</creatorcontrib><creatorcontrib>Fukuoka Stroke Registry Investigators</creatorcontrib><creatorcontrib>The participating hospitals in the Fukuoka Stroke Registry were the following</creatorcontrib><creatorcontrib>Kyushu University Hospital, National Hospital Organization Kyushu Medical Center, National Hospital Organization Fukuoka-Higashi Medical Center, Fukuoka Red Cross Hospital, St. Mary’s Hospital, Steel Memorial Yawata Hospital, Japan Labor Health and Welfare Organization Kyushu Rosai Hospital</creatorcontrib><creatorcontrib>The steering committee included the following</creatorcontrib><title>ABCD3 and ABCD3-I Scores Are Superior to ABCD2 Score in the Prediction of Short- and Long-Term Risks of Stroke After Transient Ischemic Attack</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Several risk scores have been developed to predict the stroke risk after transient ischemic attack (TIA). However, the validation of these scores in different cohorts is still limited. The objective of this study was to elucidate whether these scores were able to predict short-term and long-term risks of stroke in patients with TIA.
From the Fukuoka Stroke Registry, 693 patients with TIA were followed up for 3 years. Multivariable-adjusted Cox proportional hazards model was used to assess the hazard ratio of risk factors for stroke. The discriminatory ability of each risk score for incident stroke was estimated by using C-statistics and continuous net reclassification improvement.
The multivariable-adjusted Cox proportional hazards model revealed that dual TIA and carotid stenosis were both significant predictors for stroke after TIA, whereas abnormal diffusion-weighted image was not. ABCD3 (C-statistics 0.61) and ABCD3-I (C-statistics 0.66) scores improved the short-term predictive ability for stroke (at 7 days) compared with the ABCD2 score (C-statistics 0.54). Addition of intracranial arterial stenosis (at 3 years, continuous net reclassification improvement 30.5%; P<0.01) and exclusion of abnormal diffusion-weighted imaging (at 3 years, continuous net reclassification improvement 24.0%; P<0.05) further improved the predictive ability for stroke risk until 3 years after TIA.
The present study demonstrates that ABCD3 and ABCD3-I scores are superior to the ABCD2 score for the prediction of subsequent stroke in patients with TIA. Addition of neuroimaging in the ABCD3 score may enable prediction of long-term stroke risk after TIA.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carotid Stenosis - complications</subject><subject>Carotid Stenosis - epidemiology</subject><subject>Cohort Studies</subject><subject>Constriction, Pathologic</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Ischemic Attack, Transient - complications</subject><subject>Ischemic Attack, Transient - epidemiology</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neuroimaging</subject><subject>Neurology</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc9u2zAMxoWhw5J2e4Oi0KXALs70z7Z8dLO0CRYgQ5KdDVmmGzWxlUrKYS-xZ57qZN2JpL4fPxEkQreUTCjN6DcfnN2D2qlY8gkhnOT5BzSmKROJyJi8QuP4WCRMFMUIXXv_QghhXKaf0IgJzlPG-Bj9KR-m3zlWfYOHLFngjbYOPC4d4M3pCM5Yh4MdZHYWselx2AH-6aAxOhjbY9vizc66kAxWS9s_J1twHV4bv_eDOoyLyzaAw1unem-gD3jh9Q46o3EZgtL7z-hjqw4evlziDfr1ONtO58ly9bSYlstEC1GEpGaZbKDJUs1B5YTXMk0L2ZCcEs3yXOmmpRRyIhlo2XCeqVpQUYCkRV23Rc5v0Nez79HZ1xP4UHXGazgcVA_25KsIs2jGCI2oOKPaWe8dtNXRmU653xUl1dslqs12vfoxK-dlLHl1vkRsu7v8cKo7aN6b_q0-AvcXQHmtDm1ciTb-PxdnTWXG-F-nRpCX</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>KIYOHARA, Takuya</creator><creator>KAMOUCHI, Masahiro</creator><creator>KUMAI, Yasuhiro</creator><creator>NINOMIYA, Toshiharu</creator><creator>HATA, Jun</creator><creator>YOSHIMURA, Sohei</creator><creator>AGO, Tetsuro</creator><creator>OKADA, Yasushi</creator><creator>KITAZONO, Takanari</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>ABCD3 and ABCD3-I Scores Are Superior to ABCD2 Score in the Prediction of Short- and Long-Term Risks of Stroke After Transient Ischemic Attack</title><author>KIYOHARA, Takuya ; KAMOUCHI, Masahiro ; KUMAI, Yasuhiro ; NINOMIYA, Toshiharu ; HATA, Jun ; YOSHIMURA, Sohei ; AGO, Tetsuro ; OKADA, Yasushi ; KITAZONO, Takanari</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-b268ded65c3ea703b85598d0710c277acdf11e7082ec8d336ab4149e819bbf973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Carotid Stenosis - complications</topic><topic>Carotid Stenosis - epidemiology</topic><topic>Cohort Studies</topic><topic>Constriction, Pathologic</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Ischemic Attack, Transient - complications</topic><topic>Ischemic Attack, Transient - epidemiology</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neuroimaging</topic><topic>Neurology</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KIYOHARA, Takuya</creatorcontrib><creatorcontrib>KAMOUCHI, Masahiro</creatorcontrib><creatorcontrib>KUMAI, Yasuhiro</creatorcontrib><creatorcontrib>NINOMIYA, Toshiharu</creatorcontrib><creatorcontrib>HATA, Jun</creatorcontrib><creatorcontrib>YOSHIMURA, Sohei</creatorcontrib><creatorcontrib>AGO, Tetsuro</creatorcontrib><creatorcontrib>OKADA, Yasushi</creatorcontrib><creatorcontrib>KITAZONO, Takanari</creatorcontrib><creatorcontrib>Fukuoka Stroke Registry Investigators</creatorcontrib><creatorcontrib>The participating hospitals in the Fukuoka Stroke Registry were the following</creatorcontrib><creatorcontrib>Kyushu University Hospital, National Hospital Organization Kyushu Medical Center, National Hospital Organization Fukuoka-Higashi Medical Center, Fukuoka Red Cross Hospital, St. Mary’s Hospital, Steel Memorial Yawata Hospital, Japan Labor Health and Welfare Organization Kyushu Rosai Hospital</creatorcontrib><creatorcontrib>The steering committee included the following</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KIYOHARA, Takuya</au><au>KAMOUCHI, Masahiro</au><au>KUMAI, Yasuhiro</au><au>NINOMIYA, Toshiharu</au><au>HATA, Jun</au><au>YOSHIMURA, Sohei</au><au>AGO, Tetsuro</au><au>OKADA, Yasushi</au><au>KITAZONO, Takanari</au><aucorp>Fukuoka Stroke Registry Investigators</aucorp><aucorp>The participating hospitals in the Fukuoka Stroke Registry were the following</aucorp><aucorp>Kyushu University Hospital, National Hospital Organization Kyushu Medical Center, National Hospital Organization Fukuoka-Higashi Medical Center, Fukuoka Red Cross Hospital, St. Mary’s Hospital, Steel Memorial Yawata Hospital, Japan Labor Health and Welfare Organization Kyushu Rosai Hospital</aucorp><aucorp>The steering committee included the following</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ABCD3 and ABCD3-I Scores Are Superior to ABCD2 Score in the Prediction of Short- and Long-Term Risks of Stroke After Transient Ischemic Attack</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>45</volume><issue>2</issue><spage>418</spage><epage>425</epage><pages>418-425</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Several risk scores have been developed to predict the stroke risk after transient ischemic attack (TIA). However, the validation of these scores in different cohorts is still limited. The objective of this study was to elucidate whether these scores were able to predict short-term and long-term risks of stroke in patients with TIA.
From the Fukuoka Stroke Registry, 693 patients with TIA were followed up for 3 years. Multivariable-adjusted Cox proportional hazards model was used to assess the hazard ratio of risk factors for stroke. The discriminatory ability of each risk score for incident stroke was estimated by using C-statistics and continuous net reclassification improvement.
The multivariable-adjusted Cox proportional hazards model revealed that dual TIA and carotid stenosis were both significant predictors for stroke after TIA, whereas abnormal diffusion-weighted image was not. ABCD3 (C-statistics 0.61) and ABCD3-I (C-statistics 0.66) scores improved the short-term predictive ability for stroke (at 7 days) compared with the ABCD2 score (C-statistics 0.54). Addition of intracranial arterial stenosis (at 3 years, continuous net reclassification improvement 30.5%; P<0.01) and exclusion of abnormal diffusion-weighted imaging (at 3 years, continuous net reclassification improvement 24.0%; P<0.05) further improved the predictive ability for stroke risk until 3 years after TIA.
The present study demonstrates that ABCD3 and ABCD3-I scores are superior to the ABCD2 score for the prediction of subsequent stroke in patients with TIA. Addition of neuroimaging in the ABCD3 score may enable prediction of long-term stroke risk after TIA.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>24335223</pmid><doi>10.1161/strokeaha.113.003077</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Stroke (1970), 2014-02, Vol.45 (2), p.418-425 |
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| language | eng |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Aged Aged, 80 and over Biological and medical sciences Carotid Stenosis - complications Carotid Stenosis - epidemiology Cohort Studies Constriction, Pathologic Diffusion Magnetic Resonance Imaging Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Ischemic Attack, Transient - complications Ischemic Attack, Transient - epidemiology Japan - epidemiology Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neuroimaging Neurology Prognosis Proportional Hazards Models Registries Risk Assessment Risk Factors Stroke - epidemiology Stroke - etiology Vascular diseases and vascular malformations of the nervous system |
| title | ABCD3 and ABCD3-I Scores Are Superior to ABCD2 Score in the Prediction of Short- and Long-Term Risks of Stroke After Transient Ischemic Attack |
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