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Recurrence prediction of Essen Stroke Risk and Stroke Prognostic Instrument-II scores in ischemic stroke: A study of 5-year follow-up

  • Fan Yang
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Shuangmei Yan
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Wenting Wang
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Xiang Li
    Affiliations
    Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China
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  • Fucheng Chou
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Yihan Liu
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Sai Zhang
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Yongzhi Zhang
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Huimiao Liu
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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  • Xu Yang
    Correspondence
    Corresponding authors at: Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China (X. Yang). Department of Neurology, the First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shi Jiazhuang 050031 Hebei, China (P. Gu).
    Affiliations
    Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China
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  • Ping Gu
    Correspondence
    Corresponding authors at: Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China (X. Yang). Department of Neurology, the First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shi Jiazhuang 050031 Hebei, China (P. Gu).
    Affiliations
    Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhaung 050031, Hebei, China
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      Highlights

      • The incidences of IS recurrence and composite endpoint event increased significantly with the increase of ESRS and SPI-II scores.
      • Both ESRS and SPI- II scores could stratify the risk of 5-year IS recurrence and composite vascular events.
      • The predictive powers of ESRS and SPI- II scores are basically the same in Chinese IS patients.

      Abstract

      Objective

      To evaluate the predictive accuracy of the Essen Stroke Risk Score and the Stroke Prognostic Instrument II score on the long-term recurrence in Chinese patients with acute ischemic stroke.

      Methods

      Patients with acute ischemic stroke were enrolled and had completed ESRS and SPI-II scores. Patients were stratified according to the Essen Stroke Risk Score and Stroke Prognostic Instrument II score and were followed until stroke recurrence or composite endpoint event (stroke recurrence, myocardial infarction or cardiovascular death). We estimated stratified incidence rates and calculated the cumulative risks at 5 years using Kaplan-Meier estimates. We used receiver operating characteristic (ROC) curves to compare the predictive ability of the Essen Stroke Risk Score and Stroke Prognostic Instrument II score.

      Results

      A total of 578 patients completed the follow-up. The cumulative 5-year event rates were 32.3% (95% CI, 28.2% to 36.4%) for recurrent stroke and 37.9% (95% CI: 33.8%-42.0%) for composite endpoint event. The cumulative risk of all outcomes increased with increasing risk scores. AUC for ESRS and SPI-II risk scores were 0.613 (95% CI: 0.565–0.661) and 0.613 (95% CI: 0.564–0.662) for 5-year stroke recurrence respectively and correspondingly 0.622 (95% CI: 0.576–0.668) and 0.627 (95% CI: 0.581–0.674) for composite endpoint events.

      Conclusion

      In Chinese patients with acute ischemic stroke, both Essen Stroke Risk Score and Stroke Prognostic Instrument II scores could equally stratify the risk of 5-year recurrent stroke and combined vascular events.

      Keywords

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