Study on the risk prediction for cerebral infarction after transient ischemic attack: A STROBE compliant study

Transient ischemic attack (TIA) is often recurrent, and about one-third of patients will progress to cerebral infarction. Rapidly identifying high-risk patients is pivotal to prevent the development of cerebral infarction. Therefore, this study aimed to evaluate the value of ABCD(2) score, ABCD(2) score combined with magnetic resonance diffusion weighted imaging (DWI) and intracranial arterial magnetic resonance angiography (MRA) in predicting cerebral infarction after 2 to 30 days of transient ischemic attack (TIA). 182 patients with TIA from August 2011 to August 2014 were enrolled as study subjects, and their clinical data, test results of DWI and MRA were collected. The incidence of cerebral infarction was observed at 2 days, 7 days and 30 days after TIA in patients with TIA, through scoring according to the 7-point ABCD(2) score method proposed by Johnston. The relationship between ABCD(2) score, performances of DWI and MRA and the early incidence of cerebral infarction after TIA was analyzed. The accuracy rating of ABCD(2) score and ABCD(2) + DWI + MRA score used for predicting the early incidence of cerebral infarction after TIA were compared with each other. The incidence of cerebral infarction after TIA was 19 cases (10.4%) in 2 days, 42 cases (23.1%) in 7 days, 56 cases (30.8%) in 30 days respectively. For the ABCD(2) score of incidence of cerebral infarction 2 to 30 days after TIA, that of those with high risk was higher than that with medium risk, and that with the medium risk was higher than that with low risk (P < .05). The area under the curve of ABCD(2) + DWI + MRA score and ABCD(2) score predicting the incidence of cerebral infarction was: in 2 days: 0.782 and 0.748, in 7 days: 0.839 and 0.801, in 30 days: 0.780 and 0.757, P < .05. Compared with ABCD(2) score, ABCD(2) score combined with DWI and MRA can further improve the accuracy of prediction for cerebral infarction after TIA.