Abstract 18654: Utility of Cardiac Stroke Score in a Prospective Study of Patients With Ischemic Stroke
Background: Ischemic stroke is a major cause of death and disability. Currently, the AHA/ASA guidelines recommend cardiovascular (CV) examination, cardiac enzyme tests, and a 12-lead ECG in all stroke patients. Combining the above parameters with echo, we developed a novel Cardiac Stroke Score (CSS). We investigated whether CSS can predict 1-month CV outcomes in a prospective cohort of ischemic stroke patients.
Methods: We studied 333 patients (53.5% male; mean age 66.7 years) from an ongoing prospective stroke registry at Northwestern Memorial Hospital. The CSS was calculated based on serum troponin (<5, >5), ECG changes suggestive of ischemia (absent or present), wall motion abnormalities (absent or present) and ejection fraction (>50%, <50%), assigning a score of 0 or 1 for each of the parameters. Primary endpoints evaluated at 1 month were myocardial infarction (MI), recurrent stroke, readmission, other CV events, and cardiac death.
Results: From the overall cohort, 9 patients (2.7%) had troponin >5, 115 patients (35%) had ischemic changes on ECG, 49 patients (15%) had wall motion abnormalities, and 43 patients (13%) had EF <50%. There appears to be a greater trend between the higher CSS and readmission, death and total CV events. Please see table 1.
Conclusions: CSS appears to yield a predictive value in determining1 month CV events following an ischemic stroke. However, a larger cohort with more longitudinal follow-up is necessary to confirm our findings.
Table 1: One month CV outcomes for the cohort studied. (*= p<0.05)
- © 2013 by American Heart Association, Inc.