External Validation of Pooled Cohort Risk Equations to Predict 1-Year Clinical Outcome in Ischemic Stroke Patients

Area of Science:

• Neurology
• Cardiology
• Epidemiology

Background:

• The Pooled Cohort Risk (PCR) equations are used to assess cardiovascular risk.
• Validation of these equations in diverse populations, like Chinese patients with ischemic stroke, is crucial for accurate risk stratification.
• Understanding stroke recurrence and vascular event predictors is vital for patient management.

Purpose of the Study:

• To validate the Pooled Cohort Risk (PCR) equations in a Chinese population with ischemic stroke.
• To evaluate the prognostic value of PCR equations in predicting stroke recurrence, coronary heart disease, and vascular death.
• To explore the utility of PCR equations for risk stratification in Chinese acute ischemic stroke (AIS) and transient ischemic attack (TIA) patients.

Main Methods:

• Patients were recruited from the China National Stroke Registry.
• Clinical prediction was assessed using the C statistic.
• Univariate and multivariate logistic regressions were employed to identify risk factors.
• A total of 8287 patients (7652 AIS, 635 TIA) were analyzed with 1-year follow-up.

Main Results:

• The C statistic values for predicting 1-year stroke recurrence ranged from 0.573 to 0.584.
• For non-fatal myocardial infarction, C statistic values were 0.493-0.533.
• Vascular death prediction yielded C statistic values of 0.592.
• AIS patients in the high-PCR group (≥20%) exhibited higher 12-month cumulative rates of recurrent stroke, vascular death, and combined vascular events.

Conclusions:

• Pooled Cohort Risk (PCR) equations demonstrate potential utility in predicting and stratifying 1-year risk for recurrent stroke and combined vascular events in Chinese AIS/TIA patients.
• These equations may serve as valuable tools for clinical decision-making and risk management in this demographic.
• Further research may refine PCR equation application in the Chinese context.