Essen score in the prediction of cerebrovascular events com-pared with cardiovascular events after ischaemic stroke or transient ischaemic attack: a nationwide registry analysis
Long LI1
Ze-Ning JIN2
Yue-Song PAN3
Jing JING3
Xia MENG3
Yong JIANG3
Hao LI3
Cai-Xia GUO4
Yong-Jun WANG3
1.Department of Cardiology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China;Department of Car-diology and Beijing Key Laboratory of Hypertension,Beijing Chaoyang Hospital,Capital Medical University,Beijing,China2.Department of Cardiology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China3.Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China;China National Clinical Research Center for Neurological Diseases,Beijing,China4.Department of Cardiology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China;Department of Cardiology,Beijing Tongren Hospital,Capital Medical University,Beijing,China
摘要：BACKGROUND The Essen risk score improves stratification of patients with acute ischemic stroke by early stroke recurrence. Recent study showed it could also predict myocardial infarction (MI). This study aimed to compare the Essen score 's ability to predict cerebrovascular events with compared cardiovascular events. METHODS We included patients with acute ischaemic stroke or transient ischaemic attack within seven days from the Third China National Stroke Registry. One-year cumulative event rates of combined vascular events (a composite of MI, stroke recurrence or vascular death) and cardiac events (a composite of MI, heart failure or cardiac death) was estimated using the Kaplan-Meier met-hod. The predictive value of the Essen score was assessed with C-statistics. In multivariate Cox regression analyses, we assessed whether Essen score, etiological subtype and imaging parameters were associated with outcomes. RESULTS Of 13,012 patients were included, the cumulative one-year event rates were 10.03％ for combined vascular events and 0.77％ for cardiac events, respectively. Compared with those with an Essen score < 3, patients with an Essen score ≥ 3 were more likely to have a subsequent combined vascular event [hazard ratio (HR) = 1.39, 95％ CI: 1.24?1.55] and cardiac events (HR =2.30, 95％ CI: 1.53?3.44). The score tended to be more predictive of the risk of MI (C-statistic = 0.63, 95％ CI: 0.55?0.71) and cardiac events (C-statistic = 0.62, 95％ CI: 0.56?0.67) than stroke recurrence (C-statistic = 0.55, 95％ CI: 0.54?0.57) and combined vascular events (C-statistic = 0.56, 95％ CI: 0.54?0.57). In multivariable analysis after adjusted Essen score, patients with multiple acute in-farctions or single acute infarctions and large artery atherosclerosis subtype were independently associated with an increased risk of combined vascular events. While the cardioembolism subtype was associated with an increased risk of cardiac events. CONCLUSIONS The Essen score is potentially more suitable for risk stratification of cardiovascular events than cerebrovasc-ular events. Moreover, future predictive tools should take brain imaging findings and cause of stroke into consideration.
机标关键词：predictionregistryanalysisstrokescoreafterwithattack
论文发表日期：2022-04-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：11( 265-275 )