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A modified Essen stroke risk score for predicting recurrent cardiovascular events: development and validation.

Shigeki Sumi¹, Hideki Origasa, Kiyohiro Houkin

¹Department of Biostatistics, Graduate School of Medicine, Kurume University, Kurume, Japan.

International Journal of Stroke : Official Journal of the International Stroke Society

|July 5, 2012

Summary

A modified Essen stroke risk score improves prediction of recurrent stroke and cardiovascular events. This enhanced tool aids in identifying high-risk patients for intensified secondary prevention strategies.

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Area of Science:

Cardiovascular Medicine
Neurology
Epidemiology

Background:

The Essen stroke risk score is a common tool for predicting recurrent ischemic stroke.
A modified Essen stroke risk score was developed and validated in a large Japanese registry (EVEREST).
The study excluded patients with cardioembolic stroke and followed participants for one year.

Purpose of the Study:

To develop and validate a modified Essen stroke risk score for predicting recurrent ischemic stroke and cardiovascular events.
To compare the predictive accuracy of the modified score against the original Essen stroke risk score.
To identify high-risk individuals for targeted secondary prevention.

Main Methods:

The modified score incorporated age, hypertension, diabetes, previous cardiovascular events, smoking, waist circumference, stroke subtype, and gender.
Multiple logistic regression identified predictors and calculated c-statistics for discrimination.
Outcomes included recurrent ischemic stroke and a composite of major cardiovascular events.

Main Results:

Recurrent ischemic stroke occurred in 3.7% and cardiovascular events in 4.0% of patients within one year.
The modified score achieved c-statistics of 0.632 for recurrent stroke and 0.640 for cardiovascular events.
The modified Essen stroke risk score demonstrated superior predictive ability compared to the original score.

Conclusions:

The modified Essen stroke risk score enhances the prediction of recurrent cardiovascular events.
Patients identified as high-risk by the modified score warrant intensified secondary prevention measures.
This validated score offers improved risk stratification for ischemic stroke patients.