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Heart Beat: ABCD predicts the future for mini-strokes

Heart Beat

ABCD predicts the future for mini-strokes

Transient ischemic attacks (TIAs) are mini-strokes that fade away on their own and appear to cause no lasting damage. Appearances can be deceiving — many people go on to have a full-blown stroke within a week or so.

Is everyone who has a TIA in danger of a looming stroke? That’s what a University of Oxford stroke team wanted to know. They created a simple ABCD scale for mini-stroke victims. It assigns points in four different categories:

Age: 1 point for being 60 years or older;

Blood pressure: 1 point for systolic blood pressure above 140 or diastolic pressure above 90;

Clinical features: 2 points for weakness on one side of the body; 1 point for speech trouble but no weakness; and

Duration: 2 points for a TIA lasting 60 minutes or more; 1 point for a TIA lasting 10–59 minutes.

The team then tested how well the score worked among than 200 participants of a stroke project in Oxford, England. Those with scores under 4 were unlikely to have a stroke over the next seven days (see table), while those with scores of 5 or 6 were at much higher risk. The results were reported in the July 2, 2005, The Lancet.

The score isn’t meant to scare, but to help. The researchers say that most people with an ABCD score of 4 or lower can safely go home and see their doctor during the next few days to look for what might have caused the attack and to chart a medical plan for the future. This might include use of aspirin or other anti-platelet drug, better blood pressure control, and lifestyle changes. Those with a score of 5 or 6, though, need immediate follow-up and treatment.

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Last updated:	August 21, 2006