| Objective To study the valve of ABCD3-I+LDL score in assessment of stroke recurrence after transient ischemic attack.Methods Retrospective analysis patients who diagnosed with TIA and TIA attack within 7 days before infarction in Hospital from January 2015 to March 2019,The ABCD2、ABCD3-I and ABCD3-I+LDL-C scores were adopted to evaluate the 317 TIA patients and120 TIA attack within 7days before infarction,According to the scores the TIA patients were divided into high,medium and low risk groups.Whether the secondary cerebral infarction occurred within 7 days after TIA the patients were divided into cerebral infarction group and non cerebral infarction group.Logistic regression analysis was used to analyze the correlation between the three scores and secondary cerebral infarction within 7 days after TIA.Draw ROC curve and calculate the area under the curve(AUC),youdens index,SE and SP evaluation scores for predicting the efficacy of early stroke risk in TIA patients.At the same time,the prognosis of patients with TIA who took different antiplatelet treatment regimens was tested by χ2 test.A total of 120 patients with TIA attack before infarction were analyzed by percentage analysis of the percentage of infarction in the low,medium,and high risk groups with three scores.Results(1)A total of 317 patients with TIA were collected,of whcich 40 patients were cerebral infarction and 277 were non-cerebral infarction.The percentage of infarction within 7 days was 12.6%.Analysis of clinical data of prognostic patients in the two groups shows: clinical symptoms(weakness of one limb),duration of symptoms,Ipsilateral carotid artery stenosis,LDL-C≥1.8mmol/L,stroke history,The difference was statistically significant(p <0.05).(2)Comparison of the prognosis between the two groups of TIA.The scores of the three scoring methods were significantly higher in the infarction group(p <0.05).There were differences between the three risk groups under the three scores(p <0.001).The higher the score of the three scores,the greater the risk of infarction.(3)Logistic regression analysis of ABCD2,ABCD3-I,and ABCD3-I + LDL-C scores indicates that the OR values compared with different risk stratification groups under the three scores are compared,under the three scores.The risk of infarction were high-risk group>intermediate-risk group> low-risk group.The overall risk of each score was further compared.ABCD-I + LDL-C score> ABCD3-I score> ABCD2 score.With ABCD2,ABCD3-I and ABCD3-I + LDL-C scores increases,the risk of secondary cerebral infarction within 7 days is increasing.Three score AUC area were 0.817,0.912,and 0.916,which were greater than the baseline 0.5,the difference was statistically significant(p <0.001),the best cutoff values under the three scores of ABCD2,ABCD3-I and ABCD3-I + LDL-C were 3.5,5.5,and 6.5,and the Youdens indices at the best cutoff values were 0.492,0.630,and 0.652.All three scores can truly predict the risk of early cerebral infarction after TIA,and the new ABCD3-I +LDL-C is more diagnostic value for the risk of early progression to cerebral infarction.At the same time,SE and SP are calculated based on the best cutoff value.The SE predictive value of ABCD2,ABCD3-I,ABCD3-I + LDL-C is basically the same,but the false positive rate of ABCD3-I + LDL-C is the lowest,and the predictive value of SP is highest.(4)At the same time,the patients were compared with different antiplatelet treatment regimens.The incidence of infarction was different in the three groups(χ2 = 11.445 p<0.001).(5)120 patients with a history of TIA onset within 7 days before the infarction.As the score increased,ABCD3-I,ABCD3-I + LDL-C scores increased significantly in the percentage of infarcts in the middle and high risk groups,and the difference was statistically significant(χ2 = 35.738 <0.001),And confirming that as the ABCD2,ABCD3-I,and ABCD3-I + LDL-C scores increase,the risk of early progression to cerebral infarction increases.Conclusion 1.ABCD2,ABCD3-I and ABCD3-I + LDL-C scores can have clinical predictive value for the risk of cerebral infarction in the early stage after TIA,and the ABCD3-I + LDL-C has higher predictive value.2.Whether early antiplatelet treatment and different antiplatelet treatment schemes have a great impact on the early progression of TIA to cerebral infarction。3.whether adding different treatment schemes of TIA to the score can further improve the predictive value. |
PDF Full Text Request