title: Predicting asymptomatic coronary artery disease in patients with ischemic stroke and transient ischemic attack: the PRECORIS score.
abstract: OBJECTIVE
  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.
authors.affiliation: From Paris Descartes University, Centre de Psychiatrie et Neurosciences INSERM UMR 894, Paris, France (D.C., G.T., J.-L.M.); Department of Neurology, Centre Hospitalier Sainte-Anne, Paris, France (D.C., G.T., J.-L.M.); Departments of Neurology (D.S., J.Y., J.H.H.) and Radiology (B.W.C.), Yonsei University College of Medicine, Seoul, Korea; and Department of Radiology, Centre Cardiolique du Nord, Saint-Denis, France (J.-L.S.).
authors.forename: David
authors.initials: D
authors.lastname: Calvet
authors.forename: Dongbeom
authors.initials: D
authors.lastname: Song
authors.forename: Joonsang
authors.initials: J
authors.lastname: Yoo
authors.forename: Guillaume
authors.initials: G
authors.lastname: Turc
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Sablayrolles
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Choi
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Mas
mesh_terms: D000368:Aged; D044466:Asian People; D002545:Brain Ischemia / Q000150:complications*; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis; D005260:Female; D005544:Forecasting; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D020521:Stroke / Q000150:complications*; D014057:Tomography, X-Ray Computed
keywords: coronary artery disease; risk factors