ABCD2 and ABCD3-I scores in a TIA population with low stroke risk

Abstract

Background Several clinical risk scores have been developed to predict stroke risk after transient ischemic attack (TIA). We aimed to evaluate the ABCD3-I score and compare it with the ABCD2 score in short and long-term stroke risk prediction in our post TIA stroke risk study, MIDNOR TIA. Methods We performed a prospective, multicenter study in Central Norway from October, 2012, to July, 2015, enrolling 577 patients with TIA. In a subset of patients (n=305) we calculated the AUC statistics of the ABCD3-I score and compared this with the ABCD2 score at 1 week, 3 months and 1 year. To assess stroke occurrences, data obtained by telephone follow-up and registry data from the Norwegian Stroke Register was used. Results Three hundred and five patients had complete data for both ABCD3-I and ABCD2 scores. Within 1 week, 3 months and 1 year, 1.0% (n=3), 3.3% (n=10) and 5.2% (n=16) experienced a stroke, respectively. The AUCs for the ABCD3-I score were 0.72 (95% CI, 0.54 to 0.89) at 1 week (compared with ABCD2 score p =0.019), 0.66 (95% CI, 0.53 to 0.80) at 3 months ( p =0.11), and 0.68 (0.95% CI, 0.56 to 0.79) at 1 year ( p =0.39). Conclusions The ABCD3-I score had limited value in short term prediction of subsequent stroke after TIA and did not reliably discriminate between low and high-risk patients in long-term follow-up. The ABCD2 score did not predict subsequent stroke accurately at any time point. Since modern treatment regimens and a decrease in risk factors in the population have contributed to a generally lower stroke risk after TIA during the last years, the benefit of these clinical risk scores and their role in TIA management seems limited.

Predictive Value of the ABCD3-I for Short- and Long-Term Stroke after TIA with or without sICAS

“…First, monitoring high long-term risk of cardiovascular in patients with TIA would be necessary. However, few studies analyzed performance of ABCD3-I at long-term stroke risk prediction after TIA 15,20) . Whether ABCD3-I score exhibits the same excellent predictive value for longterm stroke risk as short-term in patients with TIA is unclear.…”