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Abstract
Objective: Transient ischemic attacks (TIAs) are divided into anterior and posterior circulation types (AC-TIA, PC-TIA, respectively). In the present study, we sought to evaluate the ABCD2 score for predicting stroke in either AC-TIA or PC-TIA. Methods: We prospectively studied 369 consecutive patients who presented with TIA between June 2009 and December 2012. The 7 d occurrence of stroke after TIA was recorded and correlated with the ABCD2 score with regards to AC-TIA or PC-TIA. Results: Overall, 273 AC-TIA and 96 PC-TIA patients were recruited. Twenty-one patients with AC-TIA and seven with PC-TIA developed a stroke within the subsequent 7 d (7.7% vs. 7.3%, p = 0.899). The ABCD2 score had a higher predictive value of stroke occurrence in AC-TIA (the AUC was 0.790; 95% CI, 0.677–0.903) than in PC-TIA (the AUC was 0.535; 95% CI, 0.350–0.727) and the z-value of two receiver operating characteristic (ROC) curves was 2.24 (p = 0.025). AC-TIA resulted in a higher incidence of both unilateral weakness and speech disturbance and longer durations of the symptoms. Inversely, PC-TIA was associated with a higher incidence of diabetes mellitus (19.8% vs. 10.6%, p = 0.022). Evaluating each component of scores, age ≥ 60 yr (OR = 7.010, 95% CI 1.599–30.743), unilateral weakness (OR = 3.455, 95% CI 1.131–10.559), and blood pressure (OR = 9.652, 95% CI 2.202–42.308) were associated with stroke in AC-TIA, while in PC-TIA, diabetes mellitus (OR = 9.990, 95% CI 1.895–52.650) was associated with stroke. Conclusion: In our study, the ABCD2 score could predict the short-term risk of stroke after AC-TIA, but might have limitation for PC-TIA.