Risk Evaluation Study On Recurrence In Ischemic Stroke Patients

Objective: To explore the value of recurrence risk evaluation with revised EssenStroke Risk Score (ESRS) in ischemic stroke patients.Methods:26ischemic stroke patients and6normal control persons wereobserved to verify the accuracy of ESRS on recurrence risk evaluation. Withhigh-resolution MR imaging on carotid artery, carotid plaques was analyzed andwas followed up after1year. Primary ESRS was revised by introducing someindexes of carotid plaques stability. The value of revised ESRS on recurrence riskevaluation was studied and compared with primary ESRS.Results:1. ROC curve of primary ESRS was made. AUC0.792(95％CI,0.589~0.994)，≥3scores was the high-risk population of recurrence.2. In strokeand recurrent patients, it showed a thick vessel wall of carotid artery, eccentricplaque, un-even signals inside the plaque, large LRNC, as well as discontinuousfibrous cap.3. There a significant statistic difference between vulnerable andstable plaque (P=0.001, P＜0.05) on recurrence risk evaluation.4. There is asignificant statistic difference of TVA, VWA and NWI between stroke and normalcontrol patient&recurrence and non-recurrence patients respectively（P=0.001~0.019，P<0.05）.5. ROC curve of revised ESRS was made, AUC0.992(95％CI,0.000~1.000).≥5scores was the high-risk population ofrecurrence.6. ROC curve of revised ESRS locates in the upper-left of primaryESRS, indicating revised ESRS is better than primary ESRS on recurrence riskevaluation.Conclusions:1. ESRS is effective in recurrence risk evaluation in ischemicpatients with accuracy of79.2%.≥3scores indicated a high-risk of recurrence.2.The characteristics of carotid plaque and morphology of artery was clearlyshowed with high-resolution MR imaging.3. There is a bigger value of TVA,VWA and NWI in stroke and recurrent patients. The bigger plaque burden is, the higher recurrence risk is.4. Revised ESRS is effective in recurrence riskevaluation in ischemic patients with accuracy of99.2%.≥5scores indicated ahigh-risk of recurrence.5. Revised ESRS is much valuable than the primaryESRS on recurrence risk evaluation.