The Essen Stroke Risk Score Predicts Recurrent Cardiovascular Events A Validation Within the REduction of Atherothrombosis for Continued Health (REACH) Registry

被引:166
作者
Weimar, Christian [1 ]
Diener, Hans-Christoph [1 ]
Alberts, Mark J. [2 ]
Steg, P. Gabriel [3 ]
Bhatt, Deepak L. [4 ]
Wilson, Peter W. F. [5 ]
Mas, Jean-Louis [6 ]
Roether, Joachim [7 ]
机构
[1] Univ Duisburg Essen, Dept Neurol, D-45122 Essen, Germany
[2] Northwestern Univ, Sch Med, Div Neurol, Chicago, IL USA
[3] Univ Paris 07, Hop Bichat Claude Bernard, APHP, F-75221 Paris 05, France
[4] Cleveland Clin, Dept Cardiovasc Med, Cleveland, OH 44106 USA
[5] Emory Univ, Sch Med, Div Cardiol, Atlanta, GA 30322 USA
[6] Hop St Anne, Ctr Raymond Garcin, Serv Neurol, F-75674 Paris, France
[7] Hannover Med Sch, Klinikum Minden, Dept Neurol, Minden, Germany
关键词
ischemic stroke; risk prediction; secondary prevention; vascular events; TRANSIENT ISCHEMIC ATTACKS; MYOCARDIAL-INFARCTION; SECONDARY PREVENTION; OUTPATIENTS;
D O I
10.1161/STROKEAHA.108.521419
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Predictive scores are important tools for stratifying patients based on the risk of future (cerebro) vascular events and for selecting potential prevention therapy. Recently, the Essen Stroke Risk Score (ESRS) was derived from cerebrovascular patients in the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) trial. We aimed to validate the ESRS in a large cohort of outpatients with previous transient ischemic attack or stroke from the REduction of Atherothrombosis for Continued Health (REACH) Registry. Methods-We included 15 605 outpatients with a qualifying stroke or transient ischemic attack and with clinical follow-up at 1 year. Patients with atrial fibrillation were excluded. We stratified 1-year cumulative rates for fatal and nonfatal stroke as well as combined major cardiovascular events (cardiovascular death, myocardial infarction, and stroke) by the individually calculated stroke risk profile according to the ESRS and compared it with the 1-year event rates in the CAPRIE data subset of 6431 cerebrovascular patients. Results-The 1-year rate for recurrent stroke (or combined cardiovascular events) in the stable outpatient population of REACH increased steadily and significantly from 1.82 (2.41) in patients with ESRS 0 to 6.84 (11.48) for ESRS >6. The overall as well as stratified risk of recurrent stroke and cardiovascular events was lower than for cerebrovascular patients in CAPRIE. Conclusions-In outpatients with previous stroke or transient ischemic attack, the ESRS accurately stratifies the risk of recurrent stroke or major vascular events. Patients with a high ESRS should be candidates for intensified secondary prevention strategies. (Stroke. 2009; 40: 350-354.)
引用
收藏
页码:350 / 354
页数:5
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