Department of Neurology, The Second Affiliated Hospital of GuangZhou Medical University, 250# Changgang East Road, GuangZhou, 510260, Guangdong Province, China.
Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of GuangZhou Medical University, 250# Changgang east Road, GuangZhou, 510260, Guangdong Province, China.
Curr Neurovasc Res. 2022;19(2):188-195. doi: 10.2174/1574887117666220513104303.
Coronary artery stenosis (CAS) ≥50% often coexists in patients with ischemic stroke, which leads to a significant increase in the occurrence of major vascular events after stroke. This study aimed to develop a nomogram for diagnosing the presence of ≥50% asymptomatic CAS in patients with ischemic stroke.
A primary cohort was established that included 275 non-cardioembolic ischemic stroke patients who were admitted from January 2011 to April 2013 to a teaching hospital in southern China. The preoperative data were used to construct two models by the best subset regression and the forward stepwise regression methods, and a nomogram between these models was established. The assessment of the nomogram was carried out by discrimination and calibration in an internal cohort.
Out of the two models, model 1 contained eight clinical-related variables and exhibited the lowest Akaike Information Criterion value (322.26) and highest concordance index 0.716 (95% CI, 0.654-0.778). The nomogram showed good calibration and significant clinical benefit according to calibration curves and the decision curve analysis.
The nomogram, composed of age, sex, NIHSS score on admission, hypertension history, fast glucose level, HDL cholesterol level, LDL cholesterol level, and presence of ≥50% cervicocephalic artery stenosis, can be used for prediction of ≥50% asymptomatic coronary artery disease (CAD). Further studies are needed to validate the effectiveness of this nomogram in other populations.
缺血性脑卒中患者常同时存在冠状动脉狭窄（CAS）≥50%，这导致其脑卒中后发生主要血管事件的风险显著增加。本研究旨在为缺血性脑卒中患者建立一种诊断无症状性≥50%CAS 的列线图。
我们建立了一个初级队列，其中包括 275 例非心源性缺血性脑卒中患者，他们于 2011 年 1 月至 2013 年 4 月期间入住中国南方一所教学医院。使用术前数据，通过最佳子集回归和向前逐步回归方法构建了两个模型，并在这两个模型之间建立了一个列线图。通过内部队列的区分度和校准评估了该列线图。
在这两个模型中，模型 1 包含了 8 个临床相关变量，其 Akaike 信息准则（Akaike Information Criterion，AIC）值最低（322.26），一致性指数（concordance index，CI）最高（0.716，95%置信区间：0.654-0.778）。根据校准曲线和决策曲线分析，该列线图显示了良好的校准和显著的临床获益。
该列线图由年龄、性别、入院时 NIHSS 评分、高血压病史、快速血糖水平、HDL 胆固醇水平、LDL 胆固醇水平以及颈内动脉狭窄≥50%的存在情况组成，可用于预测无症状性冠状动脉疾病（CAD）≥50%的情况。需要进一步的研究来验证该列线图在其他人群中的有效性。
