Validation of the Canadian TIA Score to Predict Subsequent Stroke Risk in Chinese TIA Patients

Background and Objectives: The Canadian TIA Score has been verified as a good predictive tool for subsequent stroke risk in Caucasian patients; however, it had insufficient external verification of other races. We aimed to validate the Canadian TIA Score in Chinese patients and compared it with ABCD2 for subsequent stroke risk after transient ischemic attack (TIA). Methods: The Third China National Stroke Registry (CNSR-III) was a nationwide, multicenter prospective registry recruiting consecutive patients with acute ischemic stroke or TIA within 7 days of the onset from August 2015 to March 2018. The Canadian TIA Score was verified in patients diagnosed with TIA from the CNSR-III (N = 1,184). The outcomes were subsequent stroke at 7 days, 14 days/discharge, 3 months, and 1 year. Outcomes were recorded by face-toface assessment or telephone interview. The prognostic performance of the scoring system was assessed by the area under the receiver operator characteristic curve (AUC). Results: Of 1,184 TIA patients (mean [IQR] age, 61.00 [53.0069.00] years; 413 women [34.88%]), there were 40 patients (3.38%) having subsequent stroke within 7 days, 45 (3.80%) within 14 days/hospitalization, 66 (5.57%) within 3 months, and 100 (8.45%) within 1 year. The Canadian TIA Score (AUC 0 63-0.68) seemed to be a better prognostic score of stroke risk than the ABCD2 score (AUC 0.61-0.62), although no significant differences were noted. In the subgroup of atypical TIA, the Canadian TIA Score showed significantly stronger predictivity than the ABCD2 score within 7 days (0.80 [0.620.98] vs. 0.52 [0.30-0.73]; difference in AUC, 0.28 [0.03-0.53]; p, 0.026), and marginal significantly stronger predictivity within 1 year (0.71 [0.61- 0.80] vs. 0.58 [0.48-0.68]; difference in AUC, 0.12 [-0.01 to 0.25]; p, 0.06). Conclusion: The Canadian TIA Score might be a better prognostic score than the ABCD2 score for post-TIA stroke risk, especially in patients with atypical TIA. (C) 2022 S. Karger AG, Basel