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Diagnostic Ability of Risk Models in the Field of Ischemic Stroke for Predicting Atherosclerotic Outcomes in Patients
Hiroki Goto1, Yuichi Saito1, Hiroaki Yaginuma1
1Department of Cardiovascular Medicine, Chiba University Hospital.
Insights
Stroke risk scores effectively predict major adverse cardiovascular events (MACE) in acute myocardial infarction (MI) patients. These models, including the Fukuoka Stroke Risk Score and Essen Stroke Risk Score, demonstrate clinical applicability for risk stratification.
Area of Science:
- Cardiology
- Neurology
- Preventive Medicine
Background:
- Myocardial infarction (MI) and ischemic stroke share common atherosclerotic pathology.
- Existing stroke risk-scoring models (Fukuoka, Essen, SPI-II) may predict cardiovascular events post-MI.
Purpose of the Study:
- To evaluate the diagnostic ability and clinical applicability of stroke risk scores for predicting atherosclerotic events after acute MI.
- To assess the utility of cerebrovascular risk models in acute myocardial infarction patients.
Main Methods:
- A multicenter retrospective study of 2016 acute MI patients who underwent percutaneous coronary intervention.
- Calculation of Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II.
- Evaluation of diagnostic ability for major adverse cardiovascular events (MACE) including cardiovascular death, recurrent MI, and ischemic stroke.
Main Results:
- During a median follow-up of 523 days, 10.8% of patients experienced MACE.
- Higher scores on all three stroke risk models were progressively associated with increased MACE risk.
- The diagnostic abilities of the Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II were similar.
Conclusions:
- Stroke risk prediction models are useful for stratifying MACE risk in acute MI patients.
- These models demonstrate applicability across different arterial territories for atherosclerotic cardiovascular disease risk stratification.
Aims:
Several risk-scoring models, including the Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II, have been developed to predict recurrent cerebrovascular events in patients with ischemic stroke. As myocardial infarction (MI) and ischemic stroke are both atherosclerotic diseases, these scoring models in the field of cerebrovascular disease may be applicable and useful for risk stratification in patients with acute MI. We therefore evaluated the diagnostic ability and clinical applicability of these stroke risk scores in predicting atherosclerotic events after acute MI.
Methods:
This multicenter retrospective study included 2016 patients with acute MI who underwent percutaneous coronary intervention and survived to discharge. The three risk-scoring models were calculated, and their diagnostic ability for major adverse cardiovascular events (MACE) after discharge, a composite of cardiovascular death, recurrent MI, and ischemic stroke, was evaluated.
Results:
During the median follow-up of 523 days, 218 (10.8%) patients experienced MACE after discharge. High values for Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II were progressively associated with an increased risk of MACE after discharge. Overall, the diagnostic abilities of the three risk scores were similar.
Conclusions:
Risk prediction models in the field of ischemic stroke, including the Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II, were useful in stratifying MACE risk in patients with acute MI. Risk-scoring models for atherosclerotic cardiovascular disease may be applicable to patient populations with other cardiovascular diseases in different arterial territories.
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