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Predicting Asymptomatic Coronary Artery Disease in Patients With Ischemic Stroke and Transient Ischemic Attack The PRECORIS Score

 David Calvet  ;  Dongbeom Song  ;  Joonsang Yoo  ;  Guillaume Turc  ;  Jean-Louis Sablayrolles  ;  Byoung Wook Choi  ;  Ji Hoe Heo  ;  Jean-Louis Mas 
 STROKE, Vol.45(1) : 82-86, 2014 
Journal Title
Issue Date
Aged ; Asian Continental Ancestry Group ; Brain Ischemia/complications* ; Cohort Studies ; Coronary Angiography ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnosis* ; Coronary Stenosis/diagnosis ; Female ; Forecasting ; Humans ; Ischemic Attack, Transient/complications* ; Male ; Middle Aged ; Prevalence ; Reproducibility of Results ; Risk Assessment ; Stroke/complications* ; Tomography, X-Ray Computed
coronary artery disease ; risk factors
BACKGROUND AND PURPOSE: Identifying occult coronary artery stenosis may improve secondary prevention of stroke patients. The aim of this study was to derive and validate a simple score to predict severe occult coronary artery stenosis in stroke patients. METHODS: We derived a score from a French hospital-based cohort of consecutive patients (n=300) who had an ischemic stroke or a transient ischemic attack and no previous history of coronary heart disease (Predicting Asymptomatic Coronary Artery Disease in Patients With Ischemic Stroke and Transient Ischemic Attack [PRECORIS] score) and validated the score in a similar Korean cohort (n=1602). In both cohorts, severe coronary artery stenosis was defined by the presence of at least 1≥50% coronary artery stenosis as detected by 64-section CT coronary angiography. RESULTS: A 5-point score (Framingham Risk Score-predicted 10-year coronary heart disease risk [≥20%=3; 10-19%=1; <10%=0] and cervicocephalic artery stenosis [≥50%=2; <50%=1; none=0]) was predictive of occult≥50% coronary artery stenosis risk in the derivation cohort (C-statistic=0.77 [0.70-0.84]) and in the validation cohort (C-statistic=0.66 [0.63-0.68]). The predictive ability of the score was even stronger when only ≥50% left main trunk disease or 3-vessel disease were considered (C-statistic=0.83 [0.74-0.92] and 0.70 [0.66-0.74] in derivation and validation cohorts, respectively). The prevalence of occult≥50% coronary artery stenosis and ≥50% left main trunk or 3-vessel disease increased gradually with the PRECORIS score, reaching 44.2% and 13.5% in derivation cohort and 49.8% and 12.8% in validation cohort in patients with a PRECORIS score≥4. CONCLUSIONS: The PRECORIS score can identify a population of stroke or transient ischemic attack patients with a high prevalence of occult severe coronary artery stenosis.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Song, Dong Beom(송동범)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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