Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China.
Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China.
J Stroke Cerebrovasc Dis. 2019 Dec;28(12):104369. doi: 10.1016/j.jstrokecerebrovasdis.2019.104369. Epub 2019 Sep 21.
Siena carotid artery stenting (CAS) risk score is developed based on Chinese internal carotid artery (ICA) stenosis patients recruited in Italy, whether it is equally applicable in Chinese remains unknown. We aimed to investigate Siena CAS risk score value for predicting stroke risk in ICA stenosis patients underwent CAS and explore additional factors for improving accuracy of scoring system.
Totally 401 patients with ICA stenosis who underwent CAS were enrolled. The clinical data (including patient characteristics, lesion features, and procedure-related features) were collected and the Siena CAS score was calculated. Stroke incidence with 30 days was documented.
The incidence of stroke was 4.5%, and the Siena CAS score in stroke patients was higher compared with nonstroke patients, further receiver operating characteristic (ROC) curve illustrated that Siena CAS score was acceptable at predicting stroke risk with area under curve (AUC) of .743 (95%CI: .638-.848). Multivariate logistic regression model revealed that Siena CAS score and current fasting-blood glucose (FBG) greater than 7.1 mmol/l independently predicted higher stroke risk; followed ROC curve disclosed that Siena CAS score combined with current FBG greater than 7.1 mmol/l was of good value in predicting stroke risk (AUC: .770 (95%CI: .677-.863)), which was numerically increased compared with Siena CAS score alone.
Siena CAS risk scoring system exhibits to be a useful tool to predict stroke risk, and the combination of Siena CAS score and current increased FBG might be a more accurate stratification for stroke risk in Chinese ICA stenosis patients after CAS.
Siena 颈动脉支架置入术（CAS）风险评分是基于意大利招募的中国颈内动脉（ICA）狭窄患者开发的，其是否同样适用于中国人尚不清楚。我们旨在研究 Siena CAS 风险评分对预测接受 CAS 的 ICA 狭窄患者中风风险的价值，并探讨用于改善评分系统准确性的其他因素。
共纳入 401 例接受 ICA 狭窄 CAS 的患者。收集了临床数据（包括患者特征、病变特征和手术相关特征），并计算了 Siena CAS 评分。记录了 30 天内的中风发生率。
中风发生率为 4.5%，中风患者的 Siena CAS 评分高于非中风患者，进一步的接受者操作特征（ROC）曲线表明 Siena CAS 评分在预测中风风险方面具有可接受的 AUC 值为 0.743（95%CI：0.638-0.848）。多变量逻辑回归模型显示，Siena CAS 评分和当前空腹血糖（FBG）大于 7.1mmol/L 独立预测更高的中风风险；随后的 ROC 曲线表明，Siena CAS 评分结合当前 FBG 大于 7.1mmol/L 对预测中风风险具有良好的价值（AUC：0.770（95%CI：0.677-0.863）），与 Siena CAS 评分单独使用相比有所提高。
Siena CAS 风险评分系统是预测中风风险的有用工具，Siena CAS 评分与当前升高的 FBG 相结合可能是预测中国 ICA 狭窄患者 CAS 后中风风险的更准确分层方法。
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