22. European Stroke Conference Epidemiology of stroke (PO 504b - 554) 504b Epidemiology of stroke Validation of a short migraine screener in patients with a TIA or stroke D. van der Willik1, N. Pelzer2, A. Algra3, G.M. Terwindt4, M.J.H. Wermer5 LUMC, Leiden, THE NETHERLANDS1, Leiden University Medical Center, Leiden, THE NETHERLANDS2, Leiden University Medical Center, Leiden, THE NETHERLANDS3, Leiden University Medical Center, Leiden, THE NETHERLANDS4, Leiden University Medical Center, Leiden, THE NETHERLANDS5 Background Migraine is an independent risk factor for stroke. To investigate the relation between migraine and stroke reliably ascertainment of migraine history is crucial. We studied the test-characteristics of a five-question migraine screener for diagnosing migraine with patients with a TIA or stroke. Methods We included patients admitted with a TIA or stroke between January 2011 and April 2012 who answered the migraine screener during their stay in a university hospital. A semi-structured tele-phone- interview was carried out to validate the migraine diagnosis according to the ICHD-II criteria by a trained medical student under supervision of study physicians. In case of ambiguous symptoms, a headache specialist was consulted. All were blinded for the results of the screener. The test-charac-teristics of the migraine screener were calculated with the final ICHD-II diagnosis as gold standard. Results Forty-nine (22.2%) of the 221 TIA or stroke patients were diagnosed with migraine. The question with the best test-characteristics was on ever presence of severe headache accompanied by hyper-sensitivity to lights and sounds (sensitivity 0.96, 95% CI 0.85-1.00; specificity 0.89, 0.85-0.94; neg-ative predictive value (PV) 0.99, 0.95-1.00; positive PV 0.71, 0.58-0.82). For assessing a history of migraine with aura the question about visual disturbances lasting 5-60 minutes followed by head-ache had a good negative PV (0.99, 0.96-1.00), but a low positive PV (0.38, 0.24-0.53). Conclusion The short migraine screener has a very high negative predictive value and a reasonable positive predictive value. Therefore, it can be used to rule out a history of migraine in patients with a TIA or stroke. To prevent misclassification bias in studies on the relation between migraine and stroke, pa-tients with a positive screener should be interviewed more extensively to verify the diagnosis. 612 © 2013 S. Karger AG, Basel Scientific Programme 505b Epidemiology of stroke Dyslipoproteinemia and asymptomatic carotid stenosis D. Veljancic1, T. Lepic2, Z. Krsmanovic3, B. Labovic4, R. Raicevic5 Military Medical Academy, Belgrade, SERBIA1, Military Medical Academy, Belgrade, SERBIA2, Military Medical Academy, Belgrade, SERBIA3, Military Medical Academy, Belgrade, SERBIA4, Military Medical Academy, Belgrade, SERBIA5 Background: Dyslipoproteinemia is a leading risk factor for the development of cerebral atheroscle-rosis and ischemic brain disease as its final complication. The aim of this study was to evaluate the significance of different lipid status parameters in clinicaly asymptomatic patients with carotid arth-ery sclerosis. Methods and results: The investigation included forty-eight patients of both gender with asymp-tomatic carotid artery stenosis. They were divided in subgroups according to the severity of col-or- duplex ultrasonography of catotid arteries, using a standard five-graded scale. There were twen-ty- two patients in the control group. The levels of HDL, LDL, oxLDL and total blood cholesterol, triglycerides, apoprotein A1 and B were determined, as well as their relative relations. The results showed that the most prominent lipid status disorder was the increase of oxLDL particles and the decrease of apo A1/apoB relation (p<0,01), followed by the increase of apoB apoprotein and LDL particles (p<0,05), while the decrease of HDL particles level showed no statistical significance. We should emphasise that those results were not always in positive correlation with the level of carotid artery stenosis grade, as well as that half of the patients had normolipidemic dyslipoproteinemia, among which almost one third had disturbed levels of apoproteins and oxLDL with normal levels of HDL and LDL particles. Conclusion: Disorders of apoprotein and LDL particles levels suggest increased risk of carotid ste-nosis in asymptomatic patients, which is of special importance in patients with normolipidemic dys-lipoproteinemia who are considered as normolipidemic if only routine lipid status analysis is done.
Karger_ESC London_2013
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