Title:Development of a Nomogram for Predicting Asymptomatic Coronary
Artery Disease in Patients with Ischemic Stroke
Volume: 19
Issue: 2
Author(s): Jie Yang, Xinguang Yang, Jun Wen, Jiayi Huang, Lihong Jiang, Sha Liao, Chun Lian, Haiyan Yao, Li Huang and Youming Long*
Affiliation:
- Department of Neurology, The Second Affiliated Hospital of GuangZhou Medical University, 250# Changgang East
Road, GuangZhou, 510260, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of
Guangdong Province and The Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital
of GuangZhou Medical University, 250# Changgang east Road, GuangZhou, 510260, Guangdong Province, China
Keywords:
Acute ischemic stroke, coronary artery disease, coronary computed tomography angiography, cerebral angiography, nomogram.
Abstract:
Background: Coronary artery stenosis (CAS) ≥50% often coexists in patients with ischemic
stroke, which leads to a significant increase in the occurrence of major vascular events after
stroke. This study aimed to develop a nomogram for diagnosing the presence of ≥50% asymptomatic
CAS in patients with ischemic stroke.
Methods: A primary cohort was established that included 275 non-cardioembolic ischemic stroke
patients who were admitted from January 2011 to April 2013 to a teaching hospital in southern China.
The preoperative data were used to construct two models by the best subset regression and the
forward stepwise regression methods, and a nomogram between these models was established. The
assessment of the nomogram was carried out by discrimination and calibration in an internal cohort.
Results: Out of the two models, model 1 contained eight clinical-related variables and exhibited the
lowest Akaike Information Criterion value (322.26) and highest concordance index 0.716 (95% CI,
0.654-0.778). The nomogram showed good calibration and significant clinical benefit according to
calibration curves and the decision curve analysis.
Conclusion: The nomogram, composed of age, sex, NIHSS score on admission, hypertension history,
fast glucose level, HDL cholesterol level, LDL cholesterol level, and presence of ≥50% cervicocephalic
artery stenosis, can be used for prediction of ≥50% asymptomatic coronary artery disease
(CAD). Further studies are needed to validate the effectiveness of this nomogram in other populations.
