Stroke Risk Assessment After Transient Ischemic Attack

ObjectiveA simple score(ABCD~2 score) was able to identify individuals at high early risk of stroke after a transient ischemic attack(TIA) both in a population-based and a hospital-referred clinic cohort.We aimed to further validate the score and explore the relationship between smoking,hyperlipoidemia,hyperhomocysteinemia and stroke risk after TIA in a cohort of hospitalized TIA patients,respectively.MethodsWe retrospectively reviewed the hospital records of consecutive patients hospitalized in our neurological department with a definite TIA according to the Fourth Cerebrovascular Disease Symposium criteria during a 2-year period.The7-point ABCD~2 score(age[＜60 years=0,≥60 years=1];blood pressure [systolic＜140 mmHg and diastolic＜90 mmHg=0,systolic≥140 mmHg and/or diastolic≥90 mmHg=1];clinical features[unilateral weakness=2,speech disturbance without weakness=1,other symptom=0];duration of symptoms[＜10 minutes=0,10 to 59 minutes=1,≥60 minutes=2];dibetes=1) was used to stratify 148 cases of TIA patients according to the score of ABCD2 criteria termed by Johnston and the incidence of cerebral infarction was observed within 2days, 7days and 90days after the presene of TIA.SPSS13.0 was used to assess the relationship between smoking,hyperlipoidemia,hyperhomocysteinemia and stroke risk after TIA,respectively.Results 69 TIA patients were classified as low risk,defined as a score of less than 4,3 have a stroke within 2 days(4.3%),5 within 7 days(7.2%) and 6 within 90 days (8.7%);51 as moderate risk with a score of 4 or 5,5 have a stroke within 2 days (9.8%),8 within 7 days(15.6%) and 10 within 90 days(17.6%);And 28 as high risk with a score of greater than 5,8 have a stroke within 2 days(28.6%),10 within 7 days(35.7%) and 13 within 90 days(46.4%).The incidence of cerebral infarction of TIA patients with a different score have a statistically significant difference(P＜0.05).smoking is risk factors for cerebral infarction after TIA and smoking group and non-smoking group of TIA patients have a statistically significant difference in cerebral infarction.TIA patients with hyperlipidemia or hyperlipidemia have no statistical significant difference vs normal group.ConclusionThe different incidence of cerebral infarction within 2days,7days and 90days after presence of TIA is related to the ABCD~2 score.The higher the score is,the higher the incidence is and vice versa,the ABCD~2 score is more effective and simple methods to predict the short term stroke risk after TIA;Smoking also can predict the risk of cerebral infarction after TIA;hyperlipidemia or hyperlipidemia have no significant effects on the incidence of cerebral infarction after TIA.