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. 2015 Mar 16;10(3):e0120105.
doi: 10.1371/journal.pone.0120105. eCollection 2015.

Prediction factors of recurrent ischemic events in one year after minor stroke

Changqing Zhang  1 , Xingquan Zhao  1 , Chunxue Wang  1 , Liping Liu  1 , Yuchuan Ding  2 , Fauzia Akbary  2 , Yuehua Pu  1 , Xinying Zou  1 , Wanliang Du  1 , Jing Jing  1 , Yuesong Pan  1 , Ka Sing Wong  3 , Yongjun Wang  1 , Yilong Wang  1 ; Chinese IntraCranial AtheroSclerosis (CICAS) Study Group
Affiliations

Prediction factors of recurrent ischemic events in one year after minor stroke

Changqing Zhang et al. PLoS One. .

Abstract

Background: The risk of a subsequent stroke following a minor stroke is high. However, there are no effective rating scales to predict recurrent stroke following a minor one. Therefore, we assessed the risk factors associated with recurrent ischemic stroke or transient ischemic attack (TIA) within one year of minor stroke onset in order to identify possible risk factors.

Methods: Eight hundred and sixty-three non-cardioembolic ischemic stroke patients in the Chinese IntraCranial AtheroSclerosis Study that presented with minor stroke, defined as an admission National Institutes of Health stroke scale (NIHSS) score of ≤3, were consecutively enrolled in our study. Clinical information and imaging features upon admission, and any recurrent ischemic stroke or TIA within one year was recorded. Cox regression was used to identify risk factors associated with recurrent ischemic stroke or TIA within the year following stroke onset.

Results: A total of 50 patients (6.1%) experienced recurrent ischemic stroke or TIA within one year of minor stroke onset. Multivariate Cox regression model identified lower admission NIHSS score (HR, 1.75; 95% CI, 1.32 to 2.33; P<0.0001), history of coronary heart disease (HR, 2.62; 95% CI, 1.17 to 5.86; P = 0.02), severe stenosis or occlusion of large cerebral artery (HR, 4.68; 95% CI, 1.87 to 11.7; P = 0.001), and multiple acute cerebral infarcts (HR, 2.61; 95% CI, 1.01 to 6.80; P = 0.05) as independent risk factors for recurrent ischemic stroke or TIA within one year.

Conclusions: Some minor stroke patients are at higher risk for recurrent ischemic stroke or TIA. Urgent and intensified therapy may be reasonable in these patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of enrollment of study population.
TIA, transient ischemic attack; NIHSS, National Institutes of Health stroke scale.
Fig 2
Fig 2. The topographical distribution of infarct lesions and etiologic subtype of minor stroke.
A. minor stroke with occlusion of left middle cerebral artery (MCA) and multiple cerebral infarcts which located in cortex, internal watershed, and posterior cortical watershed, the etiologic subtype was considered as large artery atherosclerosis. B. minor stroke with single subcortical infarction in the left MCA perforator territory but without parent artery disease, the etiologic subtype was considered as small artery occlusion.
See this image and copyright information in PMC

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