Predictive value of brain and vascular imaging including intracranial vessels in transient ischaemic attack patients: external validation of the ABCD3‐I score. Issue 7 (26th March 2013)

• Record Type: Journal Article
• Authors: Purroy, F.; Jiménez‐Caballero, P. E.; Mauri‐Capdevila, G.; Torres, M. J.; Gorospe, A.; Ramírez Moreno, J. M.; de, N. P.; Cánovas, D.; Arenillas, J.; Álvarez‐Sabín, J.; Martínez Sánchez, P.; Fuentes, B.; Delgado‐Mederos, R.; Martí‐Fàbregas, J.; Rodríguez Campello, A.; Masjuán, J.
• Is Part Of: European journal of neurology. Volume 20:Issue 7(2013:Jul.)
• Page Start: 1088
• Page End: 1093
• Publication Date: 2013-03-26
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.12141
• Languages: English
• ISSNs: 1351-5101

Abstract

<abstract abstract-type="main" id="ene12141-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ene12141-sec-0001" sec-type="section"> <title>Background and purpose</title> <p>Recently, brain and vascular imaging have been added to clinical variables to identify patients with transient ischaemic attack (TIA) with a high risk of stroke recurrence. The aim of our study was to externally validate the ABCD3‐I score and the same score taking into account intracranial circulation.</p> </sec> <sec id="ene12141-sec-0002" sec-type="section"> <title>Methods</title> <p>We analyzed data from 1137 patients with TIA from the PROMAPA study who underwent diffusion‐weighted magnetic resonance imaging (DWI) within 7 days of symptom onset. Clinical variables and diagnostic work‐up were recorded prospectively. The end‐points were subsequent stroke at 7 and 90 days follow‐up.</p> </sec> <sec id="ene12141-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 463 (40.7%) subjects fulfilled all inclusion criteria. During follow‐up, eight patients (1.7%) had a stroke within 7 days, and 14 (3.1%) had a stroke within 3 months. In the Cox proportional hazard multivariate analyses, the combination of large‐artery atherosclerosis and positive DWI remained as independent predictors of stroke recurrence at 7‐ and 90‐day follow‐up [HR 8.23, 95% confidence interval (CI) 2.89–23.46, <italic>P </italic>< 0.001]. The ABCD3‐I score was a powerful predictor of subsequent stroke. The area under the receiver operating characteristic curve was 0.83 (95% CI 0.72–0.93) at 7 days and 0.69 (95% CI 0.53–0.85) at 90 days. When we include intracranial vessel disease in the score, the area under the curve increases but the difference observed was non‐significant.</p> </sec> <sec id="ene12141-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The inclusion of vascular and neuroimaging information to clinical scales (ABCD3‐I score) provides important prognostic information and also helps management decisions, although it cannot give a complete distinction between high‐risk and low‐risk groups.</p> </sec> </abstract>