Population-based study of ABCD2 score, carotid stenosis, and atrial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study.

Hdl Handle:
http://hdl.handle.net/10147/127694
Title:
Population-based study of ABCD2 score, carotid stenosis, and atrial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study.
Authors:
Sheehan, Orla C; Kyne, Lorraine; Kelly, Lisa A; Hannon, Niamh; Marnane, Michael; Merwick, Aine; McCormack, Patricia M E; Duggan, Joseph; Moore, Alan; Moroney, Joan; Daly, Leslie; Harris, Dawn; Horgan, Gillian; Williams, Emma B; Kelly, Peter J
Affiliation:
Neurovascular Clinical Science Unit, Mater University Hospital/University College Dublin, Ireland.
Citation:
Population-based study of ABCD2 score, carotid stenosis, and atrial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study. 2010, 41 (5):844-50 Stroke
Journal:
Stroke; a journal of cerebral circulation
Issue Date:
May-2010
URI:
http://hdl.handle.net/10147/127694
DOI:
10.1161/STROKEAHA.109.571844
PubMed ID:
20299667
Abstract:
Transient ischemic attack (TIA) etiologic data and the ABCD(2) score may improve early stroke risk prediction, but studies are required in population-based cohorts. We investigated the external validity of the ABCD(2) score, carotid stenosis, and atrial fibrillation for prediction of early recurrent stroke after TIA.; Patients with TIA in the North Dublin city population (N=294 529) were ascertained by using overlapping hospital and community sources. The relations between individual ABCD(2) items, carotid stenosis, atrial fibrillation, and early stroke were examined.; In confirmed TIA cases (n=443), carotid stenosis predicted 90-day stroke (hazard ratio=2.56; 95% CI, 1.27 to 5.15, P=0.003). Stroke risk rose with increasing grade of carotid stenosis, ranging from 5.4% (95% CI, 3.3% to 8.7%) with <50% stenosis to 17.2% (95% CI, 9.7% to 29.7%) with severe stenosis/occlusion (hazard ratio=3.3; 95% CI, 1.5 to 7.4, P=0.002). In confirmed TIA cases (n=443), the ABCD(2) score performed no better than chance for prediction of 90-day stroke (c-statistic=0.55; 95% CI, 0.45 to 0.64), largely related to the 24.2% (8/33) of patients who experienced a recurrence and had low ABCD(2) scores (0-3). However, in nonspecialist-suspected TIA cases (n=700), the predictive utility improved for stroke at 28 (c-statistic=0.61; 95% CI, 0.50 to 0.72) and 90 (c-statistic=0.61; 95% CI, 0.52 to 0.71) days.; In a population-based TIA cohort, significant predictive information was provided by carotid stenosis. The ABCD(2) score had predictive utility in patients with TIA suspected by nonspecialists. Low scores occurred in several patients with stroke recurrences, suggesting that caution is needed before using the score in isolation.
Item Type:
Article
Language:
en
MeSH:
Aged; Aged, 80 and over; Atrial Fibrillation; Carotid Stenosis; Cohort Studies; Early Diagnosis; Female; Follow-Up Studies; Humans; Ireland; Ischemic Attack, Transient; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Risk Factors; Severity of Illness Index; Stroke
ISSN:
1524-4628

Full metadata record

DC FieldValue Language
dc.contributor.authorSheehan, Orla Cen
dc.contributor.authorKyne, Lorraineen
dc.contributor.authorKelly, Lisa Aen
dc.contributor.authorHannon, Niamhen
dc.contributor.authorMarnane, Michaelen
dc.contributor.authorMerwick, Aineen
dc.contributor.authorMcCormack, Patricia M Een
dc.contributor.authorDuggan, Josephen
dc.contributor.authorMoore, Alanen
dc.contributor.authorMoroney, Joanen
dc.contributor.authorDaly, Leslieen
dc.contributor.authorHarris, Dawnen
dc.contributor.authorHorgan, Gillianen
dc.contributor.authorWilliams, Emma Ben
dc.contributor.authorKelly, Peter Jen
dc.date.accessioned2011-04-07T11:21:14Z-
dc.date.available2011-04-07T11:21:14Z-
dc.date.issued2010-05-
dc.identifier.citationPopulation-based study of ABCD2 score, carotid stenosis, and atrial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study. 2010, 41 (5):844-50 Strokeen
dc.identifier.issn1524-4628-
dc.identifier.pmid20299667-
dc.identifier.doi10.1161/STROKEAHA.109.571844-
dc.identifier.urihttp://hdl.handle.net/10147/127694-
dc.description.abstractTransient ischemic attack (TIA) etiologic data and the ABCD(2) score may improve early stroke risk prediction, but studies are required in population-based cohorts. We investigated the external validity of the ABCD(2) score, carotid stenosis, and atrial fibrillation for prediction of early recurrent stroke after TIA.-
dc.description.abstractPatients with TIA in the North Dublin city population (N=294 529) were ascertained by using overlapping hospital and community sources. The relations between individual ABCD(2) items, carotid stenosis, atrial fibrillation, and early stroke were examined.-
dc.description.abstractIn confirmed TIA cases (n=443), carotid stenosis predicted 90-day stroke (hazard ratio=2.56; 95% CI, 1.27 to 5.15, P=0.003). Stroke risk rose with increasing grade of carotid stenosis, ranging from 5.4% (95% CI, 3.3% to 8.7%) with <50% stenosis to 17.2% (95% CI, 9.7% to 29.7%) with severe stenosis/occlusion (hazard ratio=3.3; 95% CI, 1.5 to 7.4, P=0.002). In confirmed TIA cases (n=443), the ABCD(2) score performed no better than chance for prediction of 90-day stroke (c-statistic=0.55; 95% CI, 0.45 to 0.64), largely related to the 24.2% (8/33) of patients who experienced a recurrence and had low ABCD(2) scores (0-3). However, in nonspecialist-suspected TIA cases (n=700), the predictive utility improved for stroke at 28 (c-statistic=0.61; 95% CI, 0.50 to 0.72) and 90 (c-statistic=0.61; 95% CI, 0.52 to 0.71) days.-
dc.description.abstractIn a population-based TIA cohort, significant predictive information was provided by carotid stenosis. The ABCD(2) score had predictive utility in patients with TIA suspected by nonspecialists. Low scores occurred in several patients with stroke recurrences, suggesting that caution is needed before using the score in isolation.-
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAtrial Fibrillation-
dc.subject.meshCarotid Stenosis-
dc.subject.meshCohort Studies-
dc.subject.meshEarly Diagnosis-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshIschemic Attack, Transient-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshProspective Studies-
dc.subject.meshRisk Factors-
dc.subject.meshSeverity of Illness Index-
dc.subject.meshStroke-
dc.titlePopulation-based study of ABCD2 score, carotid stenosis, and atrial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study.en
dc.typeArticleen
dc.contributor.departmentNeurovascular Clinical Science Unit, Mater University Hospital/University College Dublin, Ireland.en
dc.identifier.journalStroke; a journal of cerebral circulationen
dc.description.provinceLeinster-

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