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London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 719 Acute cerebrovascular events (ACE): TIA and minor strokes (PO 709 - 739) 709 Acute cerebrovascular events (ACE): TIA and minor strokes Contrasting impact of FAST-test public education campaign on behaviour after TIA and mi-nor stroke versus major stroke: a population-based study F.J. Wolters1, N.L.M. Paul2, A. Chandratheva3, L. Li4, P.M. Rothwell5 on behalf of the Oxford Vascular Study Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Rad-cliffe Hospital, Oxford, UNITED KINGDOM1, Stroke Prevention Research Unit, Nuffield De-partment of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UNITED KINGDOM2, Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UNITED KINGDOM3, Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UNITED KINGDOM4, Stroke Prevention Re-search Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Stroke Pre-vention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, UNITED KINGDOM5 BBACKGROUND: Fast medical assessment is essential after TIA and stroke. Several countries have had out public education campaigns to increase symptom recognition and reduce delays in seeking medical attention. However, since campaigns tend to focus on symptoms and signs of ma-jor stroke, individuals with TIA or minor stroke might be falsely reassured. METHODS: We deter-mined patient perception and behaviour after TIA, minor stroke (NIHSS≤5) and major stroke in the community from 2002 to 2012 in a population based study (Oxford Vascular Study) before and after the 2009 FAST (Face-Arm-Speech-Time) media campaign. RESULTS: Among 1904 consecutive patients (716 TIA, 844 minor stroke, 344 major stroke), those with major stroke were more likely to correctly diagnose their symptoms after the FAST campaign (51.2% vs 36.9%, OR 1.8, 0.8-4.0, p=0.15) and to present directly to emergency services (OR 6.5, 3.9-10.8, p<0.001), with a slight improvement in median time to calling for help (24.6 vs 30.0 mins, p=0.16). Amongst patients with TIA or minor stroke, those who correctly diagnosed their symptoms sought medical attention more quickly (median, IQR hours -2.5, 0.5-17.5 vs 7.5, 1.0-41.0; p<0.001), but correct self-diagnosis de-clined after the FAST campaign from 36.8% to 29.0% (OR 0.70, 0.55-0.89, p=0.004; minor stroke - 35.8% to 25.7%, 0.62, 0.44-0.87, p=0.005; TIA - 38.1% to 33.1%, 0.80, 0.57-1.14, p=0.21), al-though median delay in seeking medical attention was unchanged at 3.5 hours. Correct self-diagno-sis was lowest for TIA and stroke with non-FAST symptoms, particularly isolated visual symptoms (11.4%) and isolated vertigo (15.6%). CONCLUSION: The U.K. FAST campaign appears to have improved recognition and behaviour after major stroke, but symptom recognition remains poor in TIA and minor stroke and may have been adversely affected. Public education campaigns should consider potential unintended consequences of focussing only on FAST-test symptoms and on major stroke. 710 Acute cerebrovascular events (ACE): TIA and minor strokes Copeptin Predicts Recurrent Stroke after Transient Ischemic Attack M. Katan1, GM. De Marchis2, A. Weck3, H. Audebert4, S. Benik5, Ch. Foerch6, M. Seiler7, N.G. Morgenthaler8, H. Mattle9, P. Schuetz10, B. Mueller11, M. Christ-Crain12, M. Arnold13 Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA1, Department of Neurology, Inselspital, University of Bern, Bern, SWITZERLAND2, Department of Neurology, Inselspital, University of Bern, Bern, SWITZERLAND3, Department of Neurology, Charité, University Hospital Berlin, Berlin, GERMANY4, Department of Neurology, Charité, University Hospital Berlin, Berlin, GERMANY5, Department of Neurology, University Hospital Frankfurt, Frankfurt, GERMANY6, Thermo Fisher Scientific, Thermo Scientific Biomark-ers, Clinical Diagnostics, Hennigsdorf-Berlin, Berlin, GERMANY7, Department of Experimental Endocrinology, EnForCé, Charité, University Hospital Berlin, Berlin, GERMANY8, Department of Neurology, Inselspital, University of Bern, Bern, SWITZERLAND9,Medical University Depart-ment, Kantonsspital Aarau, Aarau, SWITZERLAND10, Medical University Department, Kantonsspi-tal Aarau, Aarau, SWITZERLAND11, Department of Endocrinology, University Hospital of Basel,, Basel, SWITZERLAND12, Department of Neurology, Inselspital, University of Bern, Bern, SWIT-ZERLAND13 Background: Copeptin may be helpful in early risk stratification and potentially improve clinical decision making in patients with a transient ischemic attack (TIA). This study aimed at validating copeptin in predicting future stroke as compared to established clinical variables in a prospective multicenter study. Methods: We consecutively included 302 TIA patients within 24 hours of symptom onset (Clini-calTrials. gov.NCT00878813). Clinical risk scoring using the ABCD2score was determined and co-peptin was measured in a blinded batch analysis. Patients were followed for three months to deter-mine stroke, defined as a new acute focal neurological deficit lasting longer than 24 hours or leading to death.Logistic-regression-models were fitted to estimate odds ratios and 95% confidence intervals (OR, 95% CI) for the association of copeptin with a future stroke. The discriminatory accuracy of copeptin was assessed with the area under the receiver-operating-characteristics-curve (AUC). To further estimate the incremental information of copeptin to the ABCD2score, we calculated the net reclassification improvement (NRI). Results: A total of 11 patients (3.6%) suffered from a stroke within 3 months. In a multivariate-logis-tic- regression model with ABCD2score and the Charlson comorbidity index as adjusting variables, copeptin had an OR for prediction of recurrent stroke of 3.07 (1.13-8.41, p=0.03), adjusted for the ABCD2score and the presence of any lesion on DWI in a subgroup, the OR was 3.29 (1.25-8.98, p=0.02). Copeptin improved the discriminatory ability of the ABCD2score (AUC of ABCD2 0.60, 0.46-0.74 versus AUC of the combined model 0.74, 0.53-0.87, p=0.02). Adding copeptin to the AB-CD2- score revealed a NRI of 31.2%. Conclusion: In patients with TIAs, copeptin is a validated biomarker that adds predictive informa-tion beyond the ABCD2score. If confirmed in a larger cohort it may improve site-of-care manage-ment decisions.


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