Risk Management and Healthcare Policy (Oct 2020)
Essen Stroke Risk Score Predicts Carotid Atherosclerosis in Chinese Community Populations
Abstract
Zhi-Xin Huang,1,2,* Li-Hua Chen,3,* Ran Xiong,4 Yan-Ni He,4 Zhu Zhang,1,2 Jie Zeng,5 Qiankun Cai,6 Zhenguo Liu7 1Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China; 2Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China; 3Department of Neurology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China; 5Department of Center for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People’s Republic of China; 6Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People’s Republic of China; 7Center for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA*These authors contributed equally to this work.Correspondence: Zhi-Xin HuangDepartment of Neurology, Guangdong Second Provincial General Hospital, 466 Middle Xingang Road, Guangzhou 510317, Guangdong, People’s Republic of ChinaTel/Fax +86 20 89168080Email [email protected] LiuCenter for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USAEmail [email protected]: Carotid atherosclerosis (CA) is closely related to stroke, and Framingham Risk Score (FRS) has been used for CA risk evaluation. However, FRS could only be used for subjects of up to 74 years old. The present study was to determine if Essen Stroke Risk Score (ESRS) could be used to estimate CA risk in community populations without age limits.Methods: In the present prospective multi-community screening study, we evaluated the prevalence of CA using high-resolution ultrasound in 521 males and 1039 females (35 to 91 years old). Both FRS and ESRS were calculated for the subjects. Multivariate logistic regression analysis was used to determine the predictive values of FRS and ESRS for CA in these subjects.Results: Ultrasound data showed that CA was present in 56.2% of the participants (total of 1560). Multivariate logistic regression analysis showed that ESRS was associated with CA with odds ratio (OR): 1.34 (95% confidence interval (CI), 1.12– 1.60, p=0.001). Central obesity (OR: 1.40, CI: 1.07– 1.83, p=0.015), female (OR: 0.55, CI: 0.39– 0.77, p < 0.001) and age (OR: 2.63, CI: 2.27– 3.06, p < 0.001) were also associated with CA. Based on the estimated area under curve (AUC), FRS (AUC 0.775) was better than ESRS (AUC 0.693) (z statistic 6.774, p < 0.001) for CA prediction for individuals of ≤ 74 years old. However, receiver operating characteristic analysis showed ESRS was a good CA predictor for all subjects (AUC of 0.715).Conclusion: ESRS could be used as an alternative to FRS to predict CA in community population of all age.Keywords: Essen Stroke Risk Score, ESRS, carotid atherosclerosis, risk factors, stroke
