Age but not ABCD2 score predicts any level of carotid stenosis in either symptomatic or asymptomatic side in transient ischaemic attack. Issue 9 (1st April 2015)

• Record Type: Journal Article
• Authors: Mannu, G. S.; Kyu, M. M.; Bettencourt‐Silva, J. H.; Loke, Y. K.; Clark, A. B.; Metcalf, A. K.; Potter, J. F.; Myint, P. K.
• Is Part Of: International journal of clinical practice. Volume 69:Issue 9(2015)
• Page Start: 948
• Page End: 956
• Publication Date: 2015-04-01
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12637
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" id="ijcp12637-abs-0001"> <title>Summary</title> <sec id="ijcp12637-sec-0001" sec-type="section"> <title>Background</title> <p>The ABCD<sup>2</sup> score is routinely used in assessment of transient ischaemic attack (TIA) to assess the risk of developing stroke. There remains uncertainty regarding whether the ABCD<sup>2</sup> score could be used to help predict extent of carotid artery stenosis (CAS).</p> </sec> <sec id="ijcp12637-sec-0002" sec-type="section"> <title>Objectives</title> <p>We aimed to (i) collate and analyse all available published literature on this topic and (ii) compare the data from our local population to the existing evidence base.</p> </sec> <sec id="ijcp12637-sec-0003" sec-type="section"> <title>Materials and methods</title> <p>We conducted a retrospective‐observational study over a 6‐month period using our East of England hospital‐based TIA clinic data with a catchment population of ~750, 000. We also searched the literature on studies reporting the association between ABCD<sup>2</sup> score and CAS.</p> </sec> <sec id="ijcp12637-sec-0004" sec-type="section"> <title>Results</title> <p>We included 341 patients in our observational study. The mean age in our cohort was 72.86 years (SD 10.91) with 52% male participants. ABCD<sup>2</sup> score was not significantly associated with CAS (p = 0.78). Only age > 60 years was significantly associated with ipsilateral (> 50%) and contralateral CAS (> 50% and > 70%) (p < 0.01) after controlling for other confounders. The systematic review identified four studies for inclusion and no significant association between ABCD<sup>2</sup> score and CAS was reported, confirming our findings.</p> </sec> <sec id="ijcp12637-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Our systematic review and observational study confirm that the ABCD<sup>2</sup> score does not predict CAS. However, our observational study has examined a larger number of possible predictors and demonstrates that age appears to be the single best predictor of CAS in patients presenting with a TIA. Selection of urgent carotid ultrasound scan thus should be based on individual patient's age and potential benefit of carotid intervention rather than ABCD<sup>2</sup> score.</p> </sec> </abstract>