title: Incidence of transient ischemic attack and early stroke risk: validation of the ABCD2 score in an Italian population-based study.
abstract: OBJECTIVE
  The importance of transient ischemic attack (TIA) lies on the short-term risk of stroke, and the ABCD2 score may improve early stroke risk prediction. However, population-based studies are still needed. We aimed to provide data on TIA incidence and to evaluate the ABCD2 predictive ability for early recurrent stroke in a population-based study.
  
  
  METHODS
  This study is part of a 2-year prospective community-based registry of all cerebrovascular events in the district of Udine (153 312 inhabitants), Friuli Venezia Giulia region, northeast of Italy, between April 1, 2007 and March 31, 2009. Multiple overlapping sources for finding cases were used, combining hot and cold pursuit.
  
  
  RESULTS
  We identified 178 TIA, 161 (90.4%) of which were incident. The crude overall annual TIA incidence rate per 1000 residents was 0.52 (95% confidence interval [CI], 0.45-0.61). Incidence rate was 0.45 (95% CI, 0.31-0.65) when standardized to the 2007 Italian population and 0.25 (95% CI, 0.16-0.39) when standardized to the European standard population. Estimates of stroke risk after the index TIA within 2, 7, 30, and 90 days were, respectively, 2.5% (95% CI, 0.7-6.2), 5.6% (95% CI, 2.6-10.3), 6.2% (95% CI, 3.0-11.1), and 11.2% (95% CI, 6.8-17.1). ABCD2 score was strongly associated with stroke occurrence after index TIA: the areas under the receiver operating characteristic curve at 2, 7, 30, and 90 days were, respectively, 0.85 (95% CI, 0.72-0.97), 0.69 (95% CI, 0.56-0.82), 0.69 (95% CI, 0.56-0.85), and 0.76 (95% CI, 0.67-0.86). No patients with an ABCD2 score <4 had a stroke within the 90-day follow-up period.
  
  
  CONCLUSIONS
  This study adds new data on TIA incidence and prognosis and it further validates the ability of the ABCD2 score to identify patients at early risk for stroke.
authors.affiliation: Department of Neurosciences, S. Maria della Misericordia University Hospital, and Department of Experimental and Clinical Medicine, University of Udine Medical School, Piazza Santa Maria della Misericordia, 33100 Udine, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Cancelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Janes
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Gigli
authors.forename: Anna
authors.initials: A
authors.lastname: Perelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Zanchettin
authors.forename: Giessica
authors.initials: G
authors.lastname: Canal
authors.forename: Lucio
authors.initials: L
authors.lastname: D'Anna
authors.forename: Valentina
authors.initials: V
authors.lastname: Russo
authors.forename: Fabio
authors.initials: F
authors.lastname: Barbone
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Valente
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*