Department of Neurosciences, S. Maria della Misericordia University Hospital, and Department of Experimental and Clinical Medicine, University of Udine Medical School, Piazza Santa Maria della Misericordia, 33100 Udine, Italy.
Stroke. 2011 Oct;42(10):2751-7. doi: 10.1161/STROKEAHA.110.612705. Epub 2011 Aug 11.
The importance of transient ischemic attack (TIA) lies on the short-term risk of stroke, and the ABCD2 score may improve early stroke risk prediction. However, population-based studies are still needed. We aimed to provide data on TIA incidence and to evaluate the ABCD2 predictive ability for early recurrent stroke in a population-based study.
This study is part of a 2-year prospective community-based registry of all cerebrovascular events in the district of Udine (153 312 inhabitants), Friuli Venezia Giulia region, northeast of Italy, between April 1, 2007 and March 31, 2009. Multiple overlapping sources for finding cases were used, combining hot and cold pursuit.
We identified 178 TIA, 161 (90.4%) of which were incident. The crude overall annual TIA incidence rate per 1000 residents was 0.52 (95% confidence interval [CI], 0.45-0.61). Incidence rate was 0.45 (95% CI, 0.31-0.65) when standardized to the 2007 Italian population and 0.25 (95% CI, 0.16-0.39) when standardized to the European standard population. Estimates of stroke risk after the index TIA within 2, 7, 30, and 90 days were, respectively, 2.5% (95% CI, 0.7-6.2), 5.6% (95% CI, 2.6-10.3), 6.2% (95% CI, 3.0-11.1), and 11.2% (95% CI, 6.8-17.1). ABCD2 score was strongly associated with stroke occurrence after index TIA: the areas under the receiver operating characteristic curve at 2, 7, 30, and 90 days were, respectively, 0.85 (95% CI, 0.72-0.97), 0.69 (95% CI, 0.56-0.82), 0.69 (95% CI, 0.56-0.85), and 0.76 (95% CI, 0.67-0.86). No patients with an ABCD2 score <4 had a stroke within the 90-day follow-up period.
This study adds new data on TIA incidence and prognosis and it further validates the ability of the ABCD2 score to identify patients at early risk for stroke.
短暂性脑缺血发作（TIA）的重要性在于其短期内发生中风的风险，ABCD2 评分可能有助于早期预测中风风险。然而，仍需要进行基于人群的研究。我们旨在提供 TIA 发病率数据，并在基于人群的研究中评估 ABCD2 评分对早期复发性中风的预测能力。
本研究是对意大利东北部弗留利-威尼斯朱利亚地区乌迪内区（153312 居民）在 2007 年 4 月 1 日至 2009 年 3 月 31 日期间的所有脑血管事件进行为期 2 年的前瞻性社区登记的一部分。我们使用了多种重叠的病例发现来源，包括热追和冷追。
我们共发现了 178 例 TIA，其中 161 例（90.4%）为新发病例。每 1000 名居民的 TIA 粗发生率为 0.52（95%置信区间[CI]，0.45-0.61）。按 2007 年意大利人口和欧洲标准人口校正后，发病率分别为 0.45（95%CI，0.31-0.65）和 0.25（95%CI，0.16-0.39）。指数 TIA 后 2、7、30 和 90 天内的中风风险估计值分别为 2.5%（95%CI，0.7-6.2）、5.6%（95%CI，2.6-10.3）、6.2%（95%CI，3.0-11.1）和 11.2%（95%CI，6.8-17.1）。ABCD2 评分与 TIA 后中风的发生密切相关：指数 TIA 后 2、7、30 和 90 天的受试者工作特征曲线下面积分别为 0.85（95%CI，0.72-0.97）、0.69（95%CI，0.56-0.82）、0.69（95%CI，0.56-0.85）和 0.76（95%CI，0.67-0.86）。ABCD2 评分<4 的患者在 90 天的随访期内均未发生中风。
本研究提供了 TIA 发病率和预后的新数据，并进一步验证了 ABCD2 评分在识别早期中风风险患者方面的能力。
