{"doi":"10.17615/4wj0-2b74","title":"Early stroke risk and ABCD2 score performance in tissue- vs time-defined TIA: A multicenter study","abstract":"OBJECTIVES: Stroke risk immediately after TIA defined by time-based criteria is high, and prognostic scores (ABCD2 and ABCD3-I) have been developed to assist management. The American Stroke Association has proposed changing the criteria for the distinction between TIA and stroke from time-based to tissue-based. Research using these definitions is lacking. In a multicenter observational cohort study, we have investigated prognosis and performance of the ABCD2 score in TIA, subcategorized as tissue-positive or tissue-negative on diffusion-weighted imaging (DWI) or CT imaging according to the newly proposed criteria. METHODS: Twelve centers provided data on ABCD2 scores, DWI or CT brain imaging, and follow-up in cohorts of patients with TIA diagnosed by time-based criteria. Stroke rates at 7 and 90 days were studied in relation to tissue-positive or tissue-negative subcategorization, according to the presence or absence of brain infarction. The predictive power of the ABCD2 score was determined using area under receiver operator characteristic curve (AUC) analyses. RESULTS: A total of 4,574 patients were included. Among DWI patients (n = 3,206), recurrent stroke rates at 7 days were 7.1%(95% confidence interval 5.5-9.1) after tissue-positive and 0.4% (0.2-0.7) after tissue-negative events (p diff < 0.0001). Corresponding rates in CT-imaged patients were 12.8% (9.3-17.4) and 3.0% (2.0-4.2), respectively (p diff < 0.0001). The ABCD2 score had predictive value in tissue-positive and tissue-negative events (AUC = 0.68 [95% confidence interval 0.63-0.73] and 0.73 [0.67-0.80], respectively; p sig < 0.0001 for both results, p diff = 0.17). Tissue-positive events with low ABCD2 scores and tissue-negative events with high ABCD2 scores had similar stroke risks, especially after a 90-day follow-up. CONCLUSIONS: Our findings support the concept of a tissue-based definition of TIA and stroke, at least on prognostic grounds.","journal":"UNC Libraries","year":2020,"id":109418,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.952,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":522976,"name":"A. Merwick","orcid":null,"position":1,"is_corresponding":false},{"id":522977,"name":"S Clay Johnston","orcid":null,"position":2,"is_corresponding":false},{"id":522978,"name":"J. M. Olivot","orcid":null,"position":3,"is_corresponding":false},{"id":522979,"name":"P. J. Kelly","orcid":null,"position":4,"is_corresponding":false},{"id":522980,"name":"G. W. Albers","orcid":null,"position":5,"is_corresponding":false},{"id":522981,"name":"W. D. Rosamond","orcid":null,"position":6,"is_corresponding":false},{"id":522184,"name":"Ahro Kim","orcid":"0000-0003-0836-9358","position":7,"is_corresponding":false},{"id":522982,"name":"A. W. Asimos","orcid":null,"position":8,"is_corresponding":false},{"id":522983,"name":"S. B. Coutts","orcid":null,"position":9,"is_corresponding":false},{"id":522984,"name":"M. F. Giles","orcid":null,"position":10,"is_corresponding":false},{"id":522985,"name":"A. M. Demchuk","orcid":null,"position":11,"is_corresponding":false},{"id":522986,"name":"P. M. Rothwell","orcid":null,"position":12,"is_corresponding":false},{"id":522185,"name":"Philippa C. Lavallée","orcid":"0000-0002-8148-7679","position":13,"is_corresponding":false},{"id":8338,"name":"D. Calvet","orcid":"0000-0002-9953-5333","position":14,"is_corresponding":false},{"id":522987,"name":"F. Purroy","orcid":null,"position":15,"is_corresponding":false},{"id":522988,"name":"H. Ay","orcid":null,"position":16,"is_corresponding":false},{"id":522989,"name":"E. M. Arsava","orcid":null,"position":17,"is_corresponding":false},{"id":522990,"name":"J. Labreuche","orcid":null,"position":18,"is_corresponding":false},{"id":522991,"name":"R. Sciolla","orcid":null,"position":19,"is_corresponding":false},{"id":522992,"name":"P. Amarenco","orcid":null,"position":20,"is_corresponding":false},{"id":522993,"name":"J. L. Mas","orcid":null,"position":21,"is_corresponding":false},{"id":287568,"name":"Brett Cucchiara","orcid":"0000-0002-5218-9015","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T23:12:50.712357Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}