The Essen Stroke Risk Score predicts recurrent cardiovascular events A validation within the REduction of Atherothrombosis for Continued Health (REACH) registry

Christian Weimar, Hans Christoph Diener, Mark J. Alberts, P. Gabriel Steg, Deepak L. Bhatt, Peter W F Wilson, Jean Louis Mas, Joachim Röther

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Background and Purpose-Predictive scores are important tools for stratifying patients based on the risk of future (cerebro)vascular events and for selecting potential prevention therapy. Recently, the Essen Stroke Risk Score (ESRS) was derived from cerebrovascular patients in the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) trial. We aimed to validate the ESRS in a large cohort of outpatients with previous transient ischemic attack or stroke from the REduction of Atherothrombosis for Continued Health (REACH) Registry. Methods-We included 15 605 outpatients with a qualifying stroke or transient ischemic attack and with clinical follow-up at 1 year. Patients with atrial fibrillation were excluded. We stratified 1-year cumulative rates for fatal and nonfatal stroke as well as combined major cardiovascular events (cardiovascular death, myocardial infarction, and stroke) by the individually calculated stroke risk profile according to the ESRS and compared it with the 1-year event rates in the CAPRIE data subset of 6431 cerebrovascular patients. Results-The 1-year rate for recurrent stroke (or combined cardiovascular events) in the stable outpatient population of REACH increased steadily and significantly from 1.82 (2.41) in patients with ESRS 0 to 6.84 (11.48) for ESRS >6. The overall as well as stratified risk of recurrent stroke and cardiovascular events was lower than for cerebrovascular patients in CAPRIE. Conclusions-In outpatients with previous stroke or transient ischemic attack, the ESRS accurately stratifies the risk of recurrent stroke or major vascular events. Patients with a high ESRS should be candidates for intensified secondary prevention strategies.

Original languageEnglish (US)
Pages (from-to)350-354
Number of pages5
JournalStroke
Volume40
Issue number2
DOIs
StatePublished - Feb 2009

Fingerprint

Registries
Stroke
Health
clopidogrel
Transient Ischemic Attack
Outpatients
Aspirin
Blood Vessels
Myocardial Infarction
Population Dynamics
Secondary Prevention
Atrial Fibrillation

Keywords

  • Ischemic stroke
  • Risk prediction
  • Secondary prevention
  • Vascular events

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Medicine(all)

Cite this

The Essen Stroke Risk Score predicts recurrent cardiovascular events A validation within the REduction of Atherothrombosis for Continued Health (REACH) registry. / Weimar, Christian; Diener, Hans Christoph; Alberts, Mark J.; Gabriel Steg, P.; Bhatt, Deepak L.; Wilson, Peter W F; Mas, Jean Louis; Röther, Joachim.

In: Stroke, Vol. 40, No. 2, 02.2009, p. 350-354.

Research output: Contribution to journalArticle

Weimar, Christian ; Diener, Hans Christoph ; Alberts, Mark J. ; Gabriel Steg, P. ; Bhatt, Deepak L. ; Wilson, Peter W F ; Mas, Jean Louis ; Röther, Joachim. / The Essen Stroke Risk Score predicts recurrent cardiovascular events A validation within the REduction of Atherothrombosis for Continued Health (REACH) registry. In: Stroke. 2009 ; Vol. 40, No. 2. pp. 350-354.
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AU - Diener, Hans Christoph

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AU - Gabriel Steg, P.

AU - Bhatt, Deepak L.

AU - Wilson, Peter W F

AU - Mas, Jean Louis

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AB - Background and Purpose-Predictive scores are important tools for stratifying patients based on the risk of future (cerebro)vascular events and for selecting potential prevention therapy. Recently, the Essen Stroke Risk Score (ESRS) was derived from cerebrovascular patients in the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) trial. We aimed to validate the ESRS in a large cohort of outpatients with previous transient ischemic attack or stroke from the REduction of Atherothrombosis for Continued Health (REACH) Registry. Methods-We included 15 605 outpatients with a qualifying stroke or transient ischemic attack and with clinical follow-up at 1 year. Patients with atrial fibrillation were excluded. We stratified 1-year cumulative rates for fatal and nonfatal stroke as well as combined major cardiovascular events (cardiovascular death, myocardial infarction, and stroke) by the individually calculated stroke risk profile according to the ESRS and compared it with the 1-year event rates in the CAPRIE data subset of 6431 cerebrovascular patients. Results-The 1-year rate for recurrent stroke (or combined cardiovascular events) in the stable outpatient population of REACH increased steadily and significantly from 1.82 (2.41) in patients with ESRS 0 to 6.84 (11.48) for ESRS >6. The overall as well as stratified risk of recurrent stroke and cardiovascular events was lower than for cerebrovascular patients in CAPRIE. Conclusions-In outpatients with previous stroke or transient ischemic attack, the ESRS accurately stratifies the risk of recurrent stroke or major vascular events. Patients with a high ESRS should be candidates for intensified secondary prevention strategies.

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