title: The ABCD2 score is better for stroke risk prediction after anterior circulation TIA compared to posterior circulation TIA.
abstract: OBJECTIVE
  Transient ischemic attacks (TIAs) are divided into anterior and posterior circulation types (AC-TIA, PC-TIA, respectively). In the present study, we sought to evaluate the ABCD2 score for predicting stroke in either AC-TIA or PC-TIA.
  
  
  METHODS
  We prospectively studied 369 consecutive patients who presented with TIA between June 2009 and December 2012. The 7 d occurrence of stroke after TIA was recorded and correlated with the ABCD2 score with regards to AC-TIA or PC-TIA.
  
  
  RESULTS
  Overall, 273 AC-TIA and 96 PC-TIA patients were recruited. Twenty-one patients with AC-TIA and seven with PC-TIA developed a stroke within the subsequent 7 d (7.7% vs. 7.3%, p = 0.899). The ABCD2 score had a higher predictive value of stroke occurrence in AC-TIA (the AUC was 0.790; 95% CI, 0.677-0.903) than in PC-TIA (the AUC was 0.535; 95% CI, 0.350-0.727) and the z-value of two receiver operating characteristic (ROC) curves was 2.24 (p = 0.025). AC-TIA resulted in a higher incidence of both unilateral weakness and speech disturbance and longer durations of the symptoms. Inversely, PC-TIA was associated with a higher incidence of diabetes mellitus (19.8% vs. 10.6%, p = 0.022). Evaluating each component of scores, age ≥ 60 yr (OR = 7.010, 95% CI 1.599-30.743), unilateral weakness (OR = 3.455, 95% CI 1.131-10.559), and blood pressure (OR = 9.652, 95% CI 2.202-42.308) were associated with stroke in AC-TIA, while in PC-TIA, diabetes mellitus (OR = 9.990, 95% CI 1.895-52.650) was associated with stroke.
  
  
  CONCLUSIONS
  In our study, the ABCD2 score could predict the short-term risk of stroke after AC-TIA, but might have limitation for PC-TIA.
authors.affiliation: 1Department of Neurology, Zhejiang Hospital, Hangzhou, China.
authors.forename: Junjun
authors.initials: J
authors.lastname: Wang
authors.forename: Jimin
authors.initials: J
authors.lastname: Wu
authors.forename: Rongyi
authors.initials: R
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Haitao
authors.initials: H
authors.lastname: Hu
authors.forename: Xinzhen
authors.initials: X
authors.lastname: Yin
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000145:classification / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors
keywords: ABCD2 score; anterior circulation; posterior circulation; stroke; transient ischemic attack