22. European Stroke Conference 721 Acute cerebrovascular events (ACE): TIA and minor strokes Lipoprotein phospholipase A2 level and activity are not associated with the diagnosis of acute brain ischemia. J-M. Olivot1, W. Tai2, P. George3, C. Tung4, S. Mann5, M. Garcia6, S. Kemp7, M. Mlynash8, G.W. Albers9 Stanford Stroke Center, Stanford, USA1, Stanford Stroke Center, Stanford, USA2, Stanford Stroke Center, Stanford, USA3, Stanford Stroke Center, Stanford, USA4, Stanford Stroke Center, Stanford, USA5, Stanford Stroke Center, Stanford, USA6, Stanford Stroke Center, Stanford, USA7, Stanford Stroke Center, Stanford, USA8, Stanford Stroke Center, Stanford, USA9 Background: Lipoprotein phospholipase A2 (Lp-PLA2) level is associated with an increased risk of stroke after a transient ischemic attack (TIA). TIA diagnosis is difficult. A preliminary study suggested that Lp- PLA2 activity may increase after acute brain ischemia. The aim of the present study is to evaluate this association in a prospective cohort of patients referred for suspicion of TIA. Methods: Patients referred for the acute onset of transient or minor neurological symptoms of pre-sumed ischemic mechanism were prospectively enrolled at a single academic center from April 2011-December 2012. Blood samples were collected within 24 hours after symptom onset. Lp- PLA2 mass and activity levels were assessed by diaDexus, Inc. After a systematic work-up includ-ing an acute brain MRI, a final diagnosis of minor ischemic stroke (IS), TIA, unknown or non-isch-emic event was assigned at discharge by the attending stroke neurologist. Patients with a discharge diagnosis of TIA/IS/unknown were categorized as possible and those with a diagnosis of TIA or IS as definite ischemic event. Results: 100 consecutive patients were enrolled. Discharge diagnoses were TIA n=28, median ABCD2=4 (IQR:2,5), minor IS n=30, median NIHSS=1 (IQR:1,2), unknown (10) and non-ischemic (32). Blood samples were collected after a median delay of 23 hours (IQR:17,36) after symptom onset. The median Lp-PLA2 mass levels measured after a possible (200 ng/ml, IQR: 171, 222), a defi-nite (202 ng/ml, IQR:172, 226) ischemic and a non ischemic event (192 ng/ml, IQR:168, 230), were equivalent, p=0.8. Similarly, the median Lp-PLA2 activity levels measured after a possible (185 nmol/mL/min IQR:152,216) or a definite (186 nmol/mL/min, IQR: 153,216) ischemic event were not statistically different than those measured after a non ischemic event (169 nmol/mL/min, IQR:137, 213), p=0.2. Conclusions: The results of the present study do not confirm an association between Lp-PLA2 activity level and the diagnosis of TIA or minor ischemic stroke. 726 © 2013 S. Karger AG, Basel Scientific Programme 722 Acute cerebrovascular events (ACE): TIA and minor strokes Survey of Evaluation Models for Transient Ischemic Attack in Southwest China J.J. Zhao1, F. Yu2, J. Xiao3, M.K. Zhou4, L. He5 Department of neurology, west china hospital of Sichuan university, Chengdu, CHINA1, De-partment of neurology, west china hospital of Sichuan university, Chengdu, CHINA2, Department of neurology, west china hospital of Sichuan university, Chengdu, CHINA3, Department of neurology, west china hospital of Sichuan university, Chengdu, CHINA4, Department of neurology, west china hospital of Sichuan university, Chengdu, CHINA5 Background-Three international proposed evaluation models, including hospitalization, same-day clinics and rapid evaluation units, are adopted to execute management of Transient ischemic attack (TIA). However, data on TIA evaluation models in China is sparse. Therefore, we seek to survey TIA evaluation models and the corresponding prognosis in southwest China. Methods-We retrospectively investigated patients performed TIA/cerebral infarction reporting a prior TIA successively admitted in Neurology Department of West China Hospital from December 2008 to December 2010. The detailed information included TIA evaluation models and the 90-day risk of recurrent of TIA and stroke, disability and mortality, as well as hospital bed-days and costs. Results-222 subjects had been enrolled during the two years. After the onset of TIA, 63.5% were admitted immediately, and 36.5% received no treatment or went to a clinic or emergency room until the occurrence of stroke. In the TIA patients, 90-day risk of recurrent TIA and stroke, disability and mortality was 5.9%, 2.2%, 20.7%, 1.5% respectively, with 7±3 hospital bed-days and consuming 10007 renminbi (RMB). While in cerebral infarction patients reporting a prior TIA, the above in-dexes were 2.6%, 5.2, 55.8%, 10.4% respectively, with 9±4 hospital bed-days and consuming 11649 RMB. Conclusion-The main TIA evaluation model in southwest China is hospitalization, while large pro-portions of patients received no treatment or non-standard emergency and clinic treatment until the occurrence of stroke. It is difficult to improve patient care and optimize cost-effectiveness in clin-ic or emergency room for TIA patients in southwest China. The optimal TIA evaluation model in southwest China is hospitalization immediately after TIA.
Karger_ESC London_2013
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