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ABCD2 Score May Discriminate Minor Stroke from TIA on Patient Admission

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Abstract

With the advent of time-dependent thrombolytic therapy for ischemic stroke, it has become increasingly important to differentiate transient ischemic attack (TIA) from minor stroke patients after symptom onset quickly. This study investigated the difference between TIA and minor stroke based on age, blood pressure, clinical features, duration of TIA, presence of diabetes, ABCD2 score, digital subtraction angiography (DSA) and blood lipids. One hundred seventy-one patients with clinical manifestations as transient neurological deficits in Nanjing Drum Tower Hospital were studied retrospectively. All patients were evaluated by ABCD2 score, blood lipid test, fibrinogen, and Holter electrocardiograph and DSA on admission. Patients were categorized into TIA group or minor stroke group according to CT and MRI scan 24 h within symptom onset. The study suggested that minor stroke patients were more likely to have a higher ABCD2 score (odds ratio (OR) 2.060; 95 % confidence interval (CI) 1.293–3.264). Receiver-operating characteristic curves identified ABCD2 score >4 as the optimal cut-off for minor stroke diagnosis. Total serum cholesterol seemed a better diagnostic indicator to discriminate minor stroke from TIA (OR 4.815; 95 % CI 0.946–1.654) than other blood lipids in simple logistic regression, but not valuable for the differentiation between TIA and minor stroke in multivariate logistic regression. Higher severity of intracranial internal carotid stenosis, especially >90 %, were more likely to have minor stroke, but was not a reliable diagnostic indicator (P > 0.05). ABCD2 could help clinicians to differentiate possible TIA from minor stroke at hospital admission while blood lipid parameters and artery stenosis location offer limited help.

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (81230026, 81171085, 81200896, and 81200897), the Medical Leading Talent and Innovation Team Project of Jiangsu Province (LJ201101).

Conflict of interest

There are no conflicts of interest for any of the authors relating to this manuscript.

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Authors and Affiliations

  1. Department of Neurology, Drum Tower Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China

    Hui Zhao, Qingjie Li, Mengru Lu, Yuan Shao, Jingwei Li & Yun Xu

  2. Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People’s Republic of China

    Hui Zhao, Yuan Shao, Jingwei Li & Yun Xu

Authors
  1. Hui Zhao
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  2. Qingjie Li
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  3. Mengru Lu
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  4. Yuan Shao
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  5. Jingwei Li
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  6. Yun Xu
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Corresponding authors

Correspondence to Jingwei Li or Yun Xu.

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Zhao, H., Li, Q., Lu, M. et al. ABCD2 Score May Discriminate Minor Stroke from TIA on Patient Admission. Transl. Stroke Res. 5, 128–135 (2014). https://doi.org/10.1007/s12975-013-0286-x

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  • DOI: https://doi.org/10.1007/s12975-013-0286-x

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