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(Circulation. 2007;116:II_857.)
© 2007 American Heart Association, Inc.

Cutting Edge and Miscellaneous Topics in Outcomes Research

Abstract 3770: Stroke Risk Score in Patients with Acute Coronary Syndromes. The Global Registry of Acute Coronary Events

Andrzej Budaj¹; Katarzyna Flasinska¹; Enrique P Gurfinkel²; Joel M Gore³; Jose Lopez-Sendon⁴; David Brieger⁵; Brian M Kennelly⁶; Gordon FitzGerald⁷; Keith A Fox⁸, for the GRACE Investigators

¹ Grochowski Hosp, Warsaw, Poland
² ICYCC Favaloro Foundation, Buenos Aires, Argentina
³ UMASS Med Sch, Worcester, MA
⁴ Hosp Universitario La Paz, Madrid, Spain
⁵ Concord Hosp, Concord, Australia
⁶ Hoag Memorial Hosp Presbyterian, Newport Beach, CA
⁷ UMASS Med Sch, Worcester, MA
⁸ Univ of Edinburgh, Edinburgh, United Kingdom

Background: Stroke is an uncommon but devastating complication in patients with an acute coronary syndrome (ACS), causing increased mortality. Identification of risk factors for ischemic stroke is important because of the potential to prevent this outcome through use of antithrombotic treatment and risk factor reduction.

Aim: To derive a Stroke Risk Score using data from an observational cohort study.

Methods: Data were obtained from the spectrum of ACS patients enrolled in the Global Registry of Acute Coronary Events (GRACE). A Cox model of risk factors for stroke was converted into a risk score.

Results: Among the 52,462 patients, ischemic stroke occurred in 174 (0.3%) between admission and 14 days. The median age of patients with ischemic stroke was 73 years and 46% were women vs 66 years and 33% in patients without a stroke. After multiple Cox regression analysis, the following variables were identified as independent risk factors for ischemic stroke:

Conclusion: A number of demographic and clinical features and hospital treatments are predictive of ischemic stroke. Use of the GRACE Stroke Risk Score in clinical practice may assist clinicians in selecting treatments to reduce the incidence of ischemic stroke in patients presenting with an ACS.

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