ABSTRACT
@#Objective To investigate the predictive value of TOAST（Trial of Org 10172 in Acute Stroke Treatment） and lipoprotein-associated phospholipase A2（Lp-PLA2） for early recurrence of ischemic cerebrovascular disease after transient ischemic attack（TIA）and minor ischemic stroke of anterior circulation. Methods A total of 190 patients with TIA and minor ischemic stroke of anterior circulation were selected and the general information and supplementary examinations were recorded. The patients were classified etiologically into large-artery atherosclerotic stroke（LAA） group and non-LAA group according to TOAST. According to the recurrence of ischemic cerebrovascular disease within 30 days，the patients were divided into positive event group and negative event group，and the differences between the two groups were compared. ROC curve was used to determine the best cutoff value of Lp-PLA2 for predicting positive event. Multivariate analysis was performed to identify potential predictors of recurrence. Finally，ROC curve was used to analyze the predictive value of Lp-PLA2 and LAA alone or in combination for recurrent ischemic cerebrovascular disease in the early stage of TIA and minor ischemic stroke of anterior circulation. Results For positive event group，the age，proportion of TIA or cerebral infarction history，proportion of LAA and the level of Lp-PLA2 were higher than those of negative event group（P<0.05）.The best cutoff value of Lp-PLA2 was 304.50 ng/ml（sensitivity and specificity were 0.645 and 0.711 respectively）. LAA and Lp-PLA2 ≥ 304.50 ng/ml were independent risk factors for recurrent ischemic cerebrovascular disease within 30 days after TIA and minor ischemic stroke of anterior circulation. The area under ROC curve of LAA，Lp-PLA2≥ 304.50 ng/ml and combination of both were 0.671，0.678 and 0.729 respectively. The area under ROC curve of combined prediction of LAA and Lp-PLA2 was the largest. Conclusion LAA combined with Lp-PLA2≥304.50 ng/ml could predict the risk of early recurrence of ischemic cerebrovascular disease in TIA and minor ischemic stroke of anterior circulation.