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Prediction of recurrent stroke with ABCD2 and ABCD3 scores in patients with symptomatic 50-99% carotid stenosis
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.ORCID iD: 0000-0003-0394-5096
2014 (English)In: BMC Neurology, E-ISSN 1471-2377, Vol. 14, article id 223Article in journal (Refereed) Published
Abstract [en]

Background: Although it is preferable that all patients with a recent Transient Ischemic Attack (TIA) undergo acute carotid imaging, there are centers with limited access to such acute examinations. It is controversial whether ABCD2 or ABCD3 scores can be used to triage patients to acute or delayed carotid imaging. It would be acceptable that some patients with a symptomatic carotid stenosis are detected with a slight delay as long as those who will suffer an early recurrent stroke are detected within 24 hours. The aim of this study is to analyze the ability of ABCD2 and ABCD3 scores to predict ipsilateral ischemic stroke among patients with symptomatic 50-99% carotid stenosis. Methods: In this secondary analysis of the ANSYSCAP-study, we included 230 consecutive patients with symptomatic 50-99% carotid stenosis. We analyzed the risk of recurrent ipsilateral ischemic stroke before carotid endarterectomy based on each parameter of the ABCD2 and ABCD3 scores separately, and for total ABCD2 and ABCD3 scores. We used Kaplan-Meier analysis. Results: None of the parameters in the ABCD2 or ABCD3 scores could alone predict all 12 of the ipsilateral ischemic strokes that occurred within 2 days of the presenting event, but clinical presentation tended to be a statistically significant risk factor for recurrent ipsilateral ischemic stroke (p = 0.06, log rank test). An ABCD2 score >= 2 and an ABCD3 score >= 4 could predict all 12 of these strokes as well as all 25 ipsilateral ischemic strokes that occurred within 14 days. To use ABCD3 score seems preferable over the ABCD2 score because a higher proportion of low risk patients were identified (17% of the patients had an ABCD3 score <4 while only 6% had an ABCD2 < 2). Conclusions: Although it is preferable that carotid imaging be performed within 24 hours, our data support that an ABCD3 score >= 4 might be used for triaging patients to acute carotid imaging in clinical settings with limited access to carotid imaging. However, our findings should be validated in a larger cohort study.

Place, publisher, year, edition, pages
2014. Vol. 14, article id 223
Keywords [en]
Stroke, Carotid stenosis, Risk, ABCD2, ABCD3
National Category
Neurology Neurosciences
Identifiers
URN: urn:nbn:se:umu:diva-99790DOI: 10.1186/s12883-014-0223-yISI: 000348227100002PubMedID: 25433667Scopus ID: 2-s2.0-84989347637OAI: oai:DiVA.org:umu-99790DiVA, id: diva2:788230
Available from: 2015-02-13 Created: 2015-02-12 Last updated: 2023-03-23Bibliographically approved

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Johansson, EliasWester, Per

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