Study Of Cerebral Artery Stenosis With The High Risk Ischaemic Stroke Patients Evaluated By Essen Scores

Objective: Essen Stroke Risk Score as prediction tool to judge ischemic stroke patient the risk of stroke recurrence has been recognized and applied, patients whose ESRS≥3 points have high risk of recurrent Stroke or cardiovascular death , clopidogrel should be given to strengthen the antiplatele therapy for secondary prevention strategy . However,many of the stroke recurrence factors , cerebral artery stenosis and plaque stability is the hot spot.High risk of stroke recurrence in patients with strengthened antiplatelet therapy alone is not enough . This study analyzed high risk patients evaluated by ESRS the artery stenosis and to explore more comprehensive and effective stroke prevention and treatment measures and appropriate treatment intensity and to minimize the risk of stroke recurrence..Methods: This study prospectively registered consecutive patient of our hospital with acute cerebral infarction, all patients underwent Essen Stroke risk score , and cerebral vascular imaging studies such as DSA, CTA, MRA, vascular- ultrasound and biochemical parameters such as hsCRP, blood lipids, plasma fibrino- gen. According to scores,The patients were divided into groups of low-risk group, high riskgroups, very high risk group; according to various cerebral vascular imaging , the patients were divided into stenosis group (cerebral artery stenosis≥50%) and non-stenosis group (cerebral artery stenosis <50%).According to the characteristics of atherosclerotic plaques shown by CTA and vascular ultras- ound patients were divided into stable plaque and unstable plaque group. Discussion: 1,the distribution of cerebral artery stenosis in each group divided by ESRS; 2, The best cut-off-point of ESRS to for discriminating patients with artery stenosis need intervention ;3, the distribution of plaque stability in each group divided by ESRS; (4)The relationship between Cerebral artery plaque stability and hsCRP, blood lipids, plasma fibrinogen.Results: (1)This study found 218 cases of cerebral infarction patients with vascular stenosis accounted for 68.8%; (2) ESRS low risk patients and high risk patients with arterial stenosis were significantly different(P <0.05); ROC Curve analysis the area under the curve were 0.703, P <0.05. Score of 2 is the best cut-off-point for discriminating patients with arterial stenosis need intervention ;(3) 44.7% of patients whose ESRS≥3 has unstable plaques, and significantly different from low risk group(P <0.05) ;(4) compared with stable-plaque or no-plaque group, TC, LDL, hsCRP were significantly increased in group of unstable plaques.Conclusion: 1,ESRS is a simple and reliable tool for discriminating patients with arterial stenosis and unstable plaques from those without , the best cut-off-point is 2 points. That is,when patients Essen score≥2points, need completing vascular imaging; 2,ESRS score high-risk patients with cerebral infarction need CTA and vascular ultrasound to determine plaque stability, TC, LDL, hsCRP can also be used to detemine plaque stability .