Predicting macrovascular events following TIA or minor stroke

January 01, 0001

Predicting macrovascular events following TIA or minor stroke

Predicting the macrovascular risk in patients with a TIA is important, but can be difficult to do accurately. These Dutch researchers examined the validity of currently available prediction models. They looked at 3 population-based models (Framingham, SCORE, and INDIANA project) and 4 cohort-based models (Stroke Prognosis Instrument II, Oxford TIA, Dutch TIA study, and the ABCD2 study) using a cohort of patients with new onset TIA or minor stroke (n=592). The primary outcome was a composite of the 2-year risk of nonfatal stroke, myocardial infarction, or vascular death.

The researchers found: "The 2-year risk of the primary outcome event was 12%. Calibration was adequate for stroke population-based studies. After adjustment for baseline risk and for prevalence of risk factors, calibration was adequate for the Dutch TIA, the ABCD2, and Stroke Prognosis Instrument II models. Discrimination ranged from 0.61 to 0.68."

The researchers concluded: "Discrimination was poor for all currently available risk prediction models for patients with a recent TIA or minor stroke, indicating the need for stronger predictors. Clinical usefulness may be best for the ABCD2 model, which had a limited number of easily obtainable variables, a reasonable c-statistic (0.64), and good calibration."

This paper identifies the need for a better risk predictor model for patients with a TIA

For the full abstract, click here.

Stroke 41(10):2178-2185, October 2010 © 2010 American Heart Association, Inc.
Prediction of Major Vascular Events in Patients With Transient Ischemic Attack or Ischemic Stroke: A Comparison of 7 Models. Annemarie D. Wijnhoud, Lisette Maasland, Hester F. Lingsma, Ewout W. Steyerberg, Peter J. Koudstaal, Diederik W.J. Dippel. Correspondence to Annemarie D. Wijnhoud: [email protected]

Category: N. Neurological. Keywords: TIA, stroke, risk, prediction, models, validation cohort, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 26 October 2010

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