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Association between the Suita Score and Stroke Recurrence in Patients with First-ever Ischemic Stroke: A Prospective
Yoshinori Miyamoto1, Takahiro Itaya2, Yuka Terasawa3
1Department of Cardiology, Brain Attack Center Ota Memorial Hospital, Japan.
Insights
The Suita score, used for coronary heart disease (CHD) risk, effectively predicts one-year stroke recurrence in patients with first-ever ischemic stroke or TIA. High-risk patients identified by the score showed a significantly increased chance of recurrent stroke.
Area of Science:
- Neurology
- Cardiology
- Epidemiology
Background:
- The Suita score is established for predicting 10-year coronary heart disease (CHD) risk.
- Predicting short-term stroke recurrence after a first ischemic event remains a clinical challenge.
Purpose of the Study:
- To investigate the association between the Suita score and the risk of stroke recurrence within one year following a first-ever ischemic stroke or transient ischemic attack (TIA).
Main Methods:
- A prospective cohort study involving 1,204 patients admitted for first-ever acute ischemic stroke (AIS) or TIA in Japan.
- The Suita score was calculated during hospitalization, categorizing patients into high-risk (≥5% predicted CHD risk) and low-risk groups.
- Multivariate Cox regression analysis was employed to assess the association with 1-year stroke recurrence, adjusting for relevant covariates.
Main Results:
- A significant proportion (78%) of patients were classified as high-risk for CHD based on the Suita score.
- Sixty-six patients experienced stroke recurrence within the one-year follow-up period.
- High predicted CHD risk (≥5% by Suita score) was significantly associated with an increased risk of 1-year stroke recurrence (adjusted HR = 2.20, p=0.049).
Conclusions:
- The Suita score demonstrates utility in predicting short-term stroke recurrence in patients with first-ever AIS or TIA.
- This score may serve as a valuable tool for assessing both long-term CHD prognosis and short-term stroke recurrence risk in this patient population.
Abstract:
Objective The Suita score is used to predict the 10-year prognosis of developing coronary heart disease (CHD). This study examined the association between the Suita score and stroke recurrence within one year in Japanese patients who experienced first-ever ischemic stroke. Methods This prospective cohort study at a stroke center in Japan included patients who experienced first-ever acute ischemic stroke (AIS) or a transient ischemic attack (TIA). During hospitalization, the Suita score was measured as the main exposure. Patients with a ≥5% predicted CHD risk were classified into the high-risk group. The primary outcome was stroke recurrence within one year of the stroke onset. A multivariate Cox regression analysis was conducted and adjusted for confounding and prognostic factors. Results Among the 1,204 patients evaluated, 937 (78%) were classified as having a high risk of developing CHD. Stroke recurrence was observed in 66 patients during the follow-up period. In the multivariate analysis, after adjusting for confounding and prognostic factors, such as non-small vessel occlusion and prescription of lipid-lowering agents at the time of discharge, a ≥5% predicted CHD risk was associated with the 1-year stroke recurrence after the initial onset [adjusted hazard ratio (HR) =2.20, 95% confidence interval (CI) =1.00-4.91, p=0.049; adjusted HR=2.00, 95% CI=1.01-4.14, p=0.048; adjusted HR=0.42, 95% CI=0.24-0.73, p=0.002]. Conclusion The Suita score, adapted for use in ischemic stroke with the same mechanism, correlated with the short-term recurrence within one year. Our findings suggest that the Suita score may be useful for predicting the long-term prognosis of developing CHD as well as the short-term recurrence for patients with first-ever AIS and TIA.
