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ABCD2 Score

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, defined as neurological deficit of acute onset attributed to focal ischaemia of the brain by history or examination with complete resolution of the deficit, and at least one of the following: ABCD2 score ≥6 and TIA symptoms not limited to isolated numbness, isolated visual changes, or isolated dizziness/vertigo Symptomatic intracranial arterial occlusive disease that could account for the clinical presentation, documented by transcranial Doppler or vascular imaging and defined as at least 50 (...) to first subsequent ischaemic stroke [ Time Frame: Day1-Day30 ] To demonstrate superior efficacy of ticagrelor and ASA compared with placebo and ASA in AIS/TIA patients in the prevention of ischaemic stroke at 30 days The modified Rankin Scale (mRS) score >1 at Visit 3 [ Time Frame: Day30 ] To demonstrate superior efficacy of ticagrelor and ASA compared with placebo and ASA in AIS/TIA patients in reducing overall disability at 30 days. The modified Rankin Scale (mRS) is a scale for measuring the degree

2017 Clinical Trials

82. Stroke and Cerebrovascular Diseases Registry

and has better specificity and sensitivity. Acute Brain injury, Transient Ischemic Attack is a special category of a neurological condition wherein there is an impending devastating outcome if workup is not completed in a timely fashion. There is an urgent need to do investigations with high-risk patients to prevent stroke and further mortality and morbidity. The abcd2 score can help us to risk stratify the TIA and to predict the chances of stroke in this specific cohort. However, investigators need (...) better identifiers than already present, to improve the patient changes in secondary prophylaxis of stroke prevention There is also some correlation of clinical and biochemical predictors in subarachnoid, cerebral venous thrombosis including Hunt and Hess, SAH score, WFNS-SAH grading among others with variable predictive quality. (Rosen et al; Neurocritical Care; April 2005, Volume 2, Issue 2, pp 110-118: Subarachnoid

2017 Clinical Trials

83. Optimized Remote Ischemic Conditioning (RIC) Treatment for Patients With Chronic Cerebral Ischemia

with an ischemic stroke or TIA before admission and the following requirements should be satisfied as well: The occurrence of an ischemic stroke within 30 days and with a baseline modified Rankin Scale (mRS) score≤4. The occurrence of an TIA within 15 days and with a baseline Oxfordshire Community Stroke Project on the basis of age, blood pressure (BP), clinical features, and duration of TIA symptoms (ABCD2) score≥4. 3. Patients with symptomatic intracranial atherosclerotic stenosis (sIAS) that is attributed

2017 Clinical Trials

84. Inclusion of stroke in cardiovascular risk prediction instruments

to be at the same elevated risk as patients with ischemic heart disease. Patients deemed CHD riskequivalentsincludepatientswithdiabetesmellitus(DM), those whose Framingham Heart Score calculates to a risk of 20% over 10 years, and patients with “other forms of symptomatic atherosclerotic disease.” The latter group in- cludes those with peripheral arterial disease (PAD), abdom- inal aortic aneurysm (AAA), and symptomatic carotid artery disease. Ischemic stroke unrelated to carotid artery disease is Lackland et (...) Risk Score in 2008. 9 More recently,strokehasspecificallybeenproposedasapartofthe outcome cluster in absolute risk prediction instruments rele- vant to treatment decisions, 10 although this has not been generally accepted. Reasons for including stroke as an out- come in risk prediction instruments include the social and economic burden of stroke, the significance of stroke relative toCHDinsubpopulationsoftheUnitedStates,similaritiesin approachestopreventivetreatmentinstrokeasCHD,andthe inclusion

2012 American Academy of Neurology

86. Microalbuminuria could improve risk stratification in patients with TIA and minor stroke (PubMed)

Microalbuminuria could improve risk stratification in patients with TIA and minor stroke Transient ischemic attacks (TIA) and minor strokes are important risk factors for recurrent strokes. Current stroke risk prediction scores such as ABCD2, although widely used, lack optimal sensitivity and specificity. Elevated urinary albumin excretion predicts cardiovascular disease, stroke, and mortality. We explored the role of microalbuminuria (using albumin creatinine ratio (ACR)) in predicting

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2016 Annals of clinical and translational neurology

87. Sanchitongtshu Plus Asprine for Minor Ischemic Stroke or Transient Ischemic Attack: A Randomized Double-blind Study

. Acute minor stroke was defined by a score of 3 or less at the time of randomization on the National Institutes of Health Stroke Scale(NIHSS). TIA was defined as focal brain ischemia with resolution of symptoms within 24 hours after onset plus a moderate-to-high risk of stroke recurrence(defined as a score≥4 at the time of randomization on the ABCD2). All patients were confirmed by brain CT or MRI. Patients had ability to accept the medicine and rules of the research. Patients had no serious (...) Measures : Percentage of patients with the 180-day new clinical vascular events (ischemic stroke/ hemorrhagic stroke/ TIA/ MI/ vascular death) as a cluster and evaluated individually [ Time Frame: 180 days ] Modified Rankin Scale score changes (continuous) and dichotomized at percentage with score 0-2 vs. 3-6 at 180 days follow-up [ Time Frame: 180 days ] Further efficacy exploratory analysis:Impairment (changes in NIHSS scores at 180 days follow-up) [ Time Frame: 180 days ] Further efficacy

2016 Clinical Trials

88. Analysis of the Impact of the Fragility of the Over 70 Years of TIAprognosis

with the TIA (transient ischemic attack) has however never been studied. A fortiori, the impact of the fragility of the risk of recurrent stroke after TIA is unknown. Several questions need to be asked: Among older patients hospitalized for TIA, what proportion of those completing the criteria of frailty? In this same population, is there a correlation between fragility and scores ABCD2 score itself predictive of the risk of subsequent ischemic stroke? In other words, fragile subjects who have a TIA Have (...) a higher risk of ischemic stroke (which could cause a strengthening of prevention measures)? Condition or disease Intervention/treatment Vascular Stoke Ischemic Transient Ischemic Attack Other: No intervention Detailed Description: Hypotheses : Frailty is common among the elderly patient population who have a TIA. Compared to control groups of literature. Patients with high fragility score ABCD2 also have a high score. Patients with a high score of fragility also have a significant number of vascular

2016 Clinical Trials

89. Copeptin as a biomarker for prediction of prognosis of acute ischemic stroke and transient ischemic attack: a meta-analysis. (PubMed)

and mortality compared with the National Institutes of Health Stroke Scale alone. Elevation in plasma copeptin level carried a higher risk of all-cause mortality (odds ratio=4.16; 95% CI: 2.77-6.25) and poor functional outcome (odds ratio=2.56; 95% CI: 1.97-3.32) after acute ischemic stroke. In addition, copeptin improved the prognostic value of the ABCD2 (age, blood pressure, clinical features of transient ischemic attack, duration of symptoms and presence of diabetes mellitus) score for a recurrent (...) stroke and transient ischemic attack. The Newcastle-Ottawa Quality assessment scale for cohort study was used to evaluate quality. A total of 1976 acute ischemic stroke patients from 6 studies were included, and 59% of patients were male. Patients with poor outcomes and nonsurvivors had a higher copeptin level at admission (P<0.0001). Copeptin combined with an admission National Institutes of Health Stroke Scale score significantly improved the discriminatory accuracy of functional outcome

2016 Hypertension research : official journal of the Japanese Society of Hypertension

90. An institutional study of time delays for symptomatic carotid endarterectomy. (PubMed)

a clinical database and operative records. Covariates of interest were extracted from electronic medical records. Timing and nature of the first cerebrovascular symptoms were also documented. The first medical contact and pathway of referral were also assessed. When possible, the ABCD2 score (age, blood pressure, clinical features, duration of symptoms, and diabetes) was calculated to calculate further risk of stroke. The nonparametric Wilcoxon test was used to assess differences in time intervals (...) , there was no correlation between ABCD2 risk score and waiting time for surgery.The majority of our cohort falls short of the recommended 2-week interval to perform CEA. Factors contributing to reduced CEA delay were presentation to an emergency department, in-patient investigations, and a stroke center where a vascular surgeon is available.Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

2016 Journal of Vascular Surgery

91. Articles of the month (October 2016)

. This is a large, international, double-blind, randomized, controlled trial comparing ticagrelor (180mg loading dose then 90mg BID) to aspirin (300mg loading dose then 100mg daily) in 13,199 patients with low risk stroke (NIHSS score <6) or high risk TIA (ABCD2 score >3) for 90 days. The primary outcome was a composite of stroke (ischemic or hemorrhagic), myocardial infarction, or death. It was the same in both the groups (6.7% vs 7.5%, p=0.07). Bottom line: Stick with aspirin in your CVA and TIA patients (...) a Cr measured in the 25 hours before a CT and also in the period of 24-72 hours after the scan. They also excluded patients already on dialysis and those who were given multiple contrast doses. Ultimately they ended up with 21,346 patients who they matched 1:1 based on a propensity score so they had 2 groups: contrast and no contrast. Overall, the rate of acute kidney injury was 5%. The rate was the same whether you received contrast or not (4.8% versus 5.1%, p=0.38). The incidence of emergent

2016 First10EM

92. Performing a Low-dose, Whole-body Angiography as the First Element of an Imaging Assessment Following Stroke / TIA

the past 10 days, ABCD2 score greater than 3) without haemorrhage Exclusion Criteria: The patient is currently participating in or has participated in another biomedical research study within the past three months or is currently in an exclusion period determined by a previous study. Patient under guardianship or judicial protection Refusal to sign the consent Inability to correctly inform the patient or his/her trusted person about the study The patient is pregnant, parturient, or breastfeeding

2015 Clinical Trials

93. Remote Ischemic Conditioning for Avoiding Recurrence of Symptomatic Intracranial Atherosclerotic Stenosis (sICAS)

with age from 40 to 80 years old. Patients having an ischemic stroke or a TIA prior to randomization. Patient having an ischemic stroke within 30 days with mRS score≤4 at baseline. Patient having a TIA within 15 days with Oxfordshire Community Stroke Project on the basis of age, blood pressure (BP), clinical features, and duration of TIA symptoms (ABCD2) score≥4 at baseline. The entry event is attributed to symptomatic atherosclerotic stenosis (50-99%) in an intracranial qualifying artery (carotid (...) . ] The time from randomization to the first occurrence of each component of the composite of fatal or non-fatal stroke (ischemic and hemorrhagic), fatal or non-fatal myocardial infarction, and TIA. [ Time Frame: During the first 12 months from randomization. ] Time to death from all causes from randomization. [ Time Frame: During the first 12 months from randomization. ] Other Outcome Measures: Scores assessed by National Institutes of Health Stroke Scale(NIHSS) [ Time Frame: During the first 12 months

2015 Clinical Trials

94. Platelet Reactivity in Acute Non-disabling Cerebrovascular Events

, randomized, multi-centre, open-label, active-controlled, blinded-endpoint trial (a PROBE design concerning clinical trial). A total of approximately 952 patients (40years≤Age<80years) with high-risk TIA (defined as an ABCD2 score ≥ 4 or the stenosis of offending vessel ≥ 50%) or minor ischemic stroke (defined as an NIHSS ≤ 3), who can be treated within 24 hours of symptom onset will be enrolled. Patients fulfilling all of the inclusion criteria and none of the exclusion criteria will be randomized 1:1 (...) with study drug within 24 hours of symptoms onset defined by the"last see normal"principle. TIA (Neurological deficit attributed to focal brain ischemia, with resolution of the deficit within 24 hours of symptom onset), that can be treated with study drug within 24 hours of symptoms onset and with moderate-to-high risk of stroke recurrence (ABCD2 score ≥ 4 at the time of randomization or the stenosis of offending vessel ≥ 50%). Exclusion Criteria: Diagnosis of hemorrhage or other pathology

2015 Clinical Trials

95. Cerebral Microbleeds and Early Recurrent Stroke After Transient Ischemic Attack: Results from the Korean Transient Ischemic Attack Expression Registry. (PubMed)

Cerebral Microbleeds and Early Recurrent Stroke After Transient Ischemic Attack: Results from the Korean Transient Ischemic Attack Expression Registry. The risk of early recurrent stroke after transient ischemic attack (TIA) may be modifiable by optimal treatment. Although ABCD2 scores, diffusion-weighted imaging lesions, and large artery stenosis are well known to predict early stroke recurrence, other neuroimaging parameters, such as cerebral microbleeds (CMBs), have not been well explored (...) manifestations, neuroimaging findings, and use of antithrombotics or statins also were analyzed.A total of 500 patients (mean age, 64 years; male, 291 [58.2%]; median ABCD2 score, 4) completed 90-day follow-up with guideline-based management: antiplatelets (457 [91.4%]), anticoagulants (74 [14.8%]), and statins (345 [69.0%]). Recurrent stroke occurred in 25 patients (5.0%). Compared with patients without recurrent stroke, those with recurrent stroke were more likely to have crescendo TIA (20 [4.2%] vs 4

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2015 JAMA neurology

96. Copeptin for the prediction of recurrent cerebrovascular events after transient ischemic attack: results from the CoRisk study. (PubMed)

a stroke. Although the association of copeptin with recurrent cerebrovascular events was not significant, the association with stroke alone as end point was significant. After adjusting for the ABCD2 score, a 10-fold increase in copeptin levels was associated with an odds ratio for stroke of 3.39 (95% confidence interval, 1.28-8.96; P=0.01). After addition of copeptin to the ABCD2 score, the area under the curve of the ABCD2 score improved from 0.60 (95% confidence interval, 0.46-0.74) to 0.74 (95 (...) % confidence interval, 0.60-0.88, P=0.02). In patients with MRI (n=223), the area under the curve of the ABCD3-I score increased in similar magnitude, although not significantly. Based on copeptin, 31.2% of patients were correctly reclassified across the risk categories of the ABCD2 score (net reclassification improvement; P=0.17).Copeptin improved the prognostic value of the ABCD2 score for the prediction of stroke but not TIA, and it may help clinicians in refining risk stratification for patients

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2014 Stroke

97. An assessment of the cost-effectiveness of magnetic resonance, including diffusion-weighted imaging, in patients with transient ischaemic attack and minor stroke: a systematic review, meta-analysis and economic evaluation. (PubMed)

An assessment of the cost-effectiveness of magnetic resonance, including diffusion-weighted imaging, in patients with transient ischaemic attack and minor stroke: a systematic review, meta-analysis and economic evaluation. Patients with transient ischaemic attack (TIA) or minor stroke need rapid treatment of risk factors to prevent recurrent stroke. ABCD2 score or magnetic resonance diffusion-weighted brain imaging (MR DWI) may help assessment and treatment.Is MR with DWI cost-effective (...) including on a 20-year time horizon including nine representative imaging scenarios.The pooled recurrent stroke rate after TIA (53 studies, 30,558 patients) is 5.2% [95% confidence interval (CI) 3.9% to 5.9%] by 7 days, and 6.7% (5.2% to 8.7%) at 90 days. ABCD2 score does not identify patients with key stroke causes or identify mimics: 66% of specialist-diagnosed true TIAs and 35-41% of mimics had an ABCD2 score of ≥ 4; 20% of true TIAs with ABCD2 score of < 4 had key risk factors. MR DWI (45 studies

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2014 Health technology assessment (Winchester, England)

98. Post-Stroke Disease Management

-discharge) cardiovascular events [nonfatal stroke, nonfatal myocardial infarction, and vascular death] [ Time Frame: one year ] Health-related QoL (European Quality of Life-5 Dimensions EQ-5D-3L - overall health utility score) [ Time Frame: at one year ] Co-primary endpoint Secondary Outcome Measures : Recurrent stroke (both ischemic and hemorrhagic) and TIA [ Time Frame: one year and up to three years ] Death from all causes [ Time Frame: one year and up to three years ] Functional outcome [ Time Frame (...) research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Patients with acute ischemic stroke or high-risk TIA (ABCD2≥3 or visible diffusion-weighted imaging (DWI) lesion on MRI) Age ≥ 18 years Written informed consent Exclusion Criteria: Patients living outside Tyrol Malignant or other severe

2014 Clinical Trials

99. The Middle East Dual Anti-platelet Treatment in Acute Transient Ischemic Attack

of the deficit at the time of randomization AND age, blood pressure, clinical features, duration of TIA and presence of diabetes (ABCD2) score >4 OR Minor ischemic stroke: residual deficit with NIHSS ≤3 at the time of randomization. Ability to randomize within 24 hours of time last known free of new ischemic symptoms. Head CT or MRI ruling out hemorrhage or other pathology, such as vascular malformation, tumor, or abscess, that could explain symptoms or contraindicate therapy. Ability to tolerate aspirin

2014 Clinical Trials

100. Acute Isolated Dysarthria Is Associated with a High Risk of Stroke (PubMed)

, and death. Isolated dysarthria was defined as slurring with imprecise articulation but without evidence of language dysfunction. The overall rate of stroke in this cohort was compared with that predicted by the median ABCD2 score for this group.Between 2006 and 2009, 1,528 patients were enrolled and had a 90-day follow-up. Of these, 43 patients presented with isolated acute-onset dysarthria (2.8%). Recurrent stroke occurred in 6/43 (14.0%) within 90 days of enrollment. The predicted maximal 90-day (...) stroke rate was 9.8% (based on a median ABCD2 score of 5 for the isolated dysarthria cohort). After adjusting for covariates, isolated dysarthria independently predicted stroke within 90 days (aOR: 3.96; 95% CI: 1.3-11.9; p = 0.014).The isolated dysarthria cohort carried a recurrent stroke risk comparable to that predicted by the median ABCD2 scores. Although isolated dysarthria is a nonspecific and uncommon clinical presentation of TIA, these findings support the need to view it first and foremost

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2014 Cerebrovascular Diseases Extra

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