Clinical value of ABCD2 score combined with carotid ultrasound in evaluating transient ischemic attack progressing to cerebral infarction in one week

Abstract

Objective To investigate the clinical value of ABCD2 score combined with carotid ultrasound in evaluating the progress of transient ischemic attack (TIA) into cerebral infarction within one week. Methods Ninety patients with who were treated in the Affiliated Hospital of Institute of Traditional Chinese Medicine of Changzhi from May 2017 to May 2018 were selected as study objects. The successful rate of ABCD2 score, carotid ultrasound, and the combination of them in evaluating TIA developing into cerebral infarction within one week. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of patients with TIA progressing to cerebral infarction were analyzed. Results Among the 90 TIA patients, 15 cases were in low risk, 34 cases were in medium risk and 41 cases were in high risk. In the aspect of TIA progressing to cerebral infarction within one week, low risk group had 1 case, while medium risk group had 12 cases, and high risk group had 26 cases, and the difference had statistical significance (P<0.05). Forty-four patients had unstable caeotid plaque, of which 30 cases(68.18%) progressed to cerebral infarction. Twenty-five patients had stable carotid plaque, of which 6 cases (24.00%) progressed to cerebral infarction. And 30 cases (14.29%) of 21 patients without plaue progressed to cerebral infarction. and the difference in incidence of infarction among the three groups was statistically significant (χ2=24.290, P=0.00). The sensitivity, specificity, PPV and NPV detected by ABCD2 score combined with carotid ultrasound were 76.3%, 80.4%, 74.4% and 82.0%, and the specificity and PPV were higher than those of the two single detection methods. The area under curve of ABCD2 score, carotid atherosclerosis score and carotid atherosclerosis score combined with ABCD2 score were 0.698, 0.772 and 0.907, respectively. Conclusions The ABCD2 score combined with carotid ultrasound can assess patient’s risk level by detecting the value of carotid plaque and, which has better prediction of the risk of TIA progressing to cerebral infarction within one week. Key words: ABCD2 score; Carotid ultrasound; Transient ischemic attack; Cerebral infarction