SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes

Background: Previous classification systems of acute ischemic stroke (Causative Classification System, CCS, of acute ischemic stroke, Trial of Org 10172 in Acute Stroke Treatment, TOAST) established the diagnosis of large artery disease (LAD) based on the presence or absence of carotid stenosis. How...

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Main Authors: Chrysi Bogiatzi, Thapat Wannarong, A. Ian McLeod, Marnin Heisel, Daniel Hackam, J. David Spence
Other Authors: Robarts Research Institute
Format: Article
Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/34618
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spelling th-mahidol.346182018-11-09T09:53:43Z SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes Chrysi Bogiatzi Thapat Wannarong A. Ian McLeod Marnin Heisel Daniel Hackam J. David Spence Robarts Research Institute Western University Mahidol University Medicine Background: Previous classification systems of acute ischemic stroke (Causative Classification System, CCS, of acute ischemic stroke, Trial of Org 10172 in Acute Stroke Treatment, TOAST) established the diagnosis of large artery disease (LAD) based on the presence or absence of carotid stenosis. However, carotid plaque burden is a stronger predictor of cardiovascular risk than stenosis. Our objective was to update definitions of ischemic stroke subtypes to improve the detection of LAD and to assess the validity and reliability of a new classification system: SPARKLE (Subtypes of Ischaemic Stroke Classification System). Methods: In a retrospective review of clinical research data, we compared three stroke subtype classifications: CCS, TOAST and SPARKLE. We analyzed a random sample of 275 patients presenting with minor stroke or transient ischemic attack (TIA) in an Urgent TIA Clinic in London, Ont., Canada, between 2002 and 2012. Results: There was substantial overall agreement between SPARKLE and CCS (κ = 0.75), with significant differences in the rate of detection of LAD, cardioembolic and undetermined causes of stroke or TIA. The inter-rater reliability of SPARKLE was substantial (κ = 0.76) and the intra-rater reliability was excellent (κ = 0.91). Conclusion: SPARKLE is a valid and reliable classification system, providing advantages compared to CCS and TOAST. The incorporation of plaque burden into the classification of LAD increases the proportion of cases attributable to LAD and reduces the proportion classified as being of 'undetermined' etiology. © 2014 S. Karger AG, Basel. 2018-11-09T02:53:43Z 2018-11-09T02:53:43Z 2014-01-01 Article Neuroepidemiology. Vol.42, No.4 (2014), 243-251 10.1159/000362417 14230208 02515350 2-s2.0-84901081022 https://repository.li.mahidol.ac.th/handle/123456789/34618 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84901081022&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Chrysi Bogiatzi
Thapat Wannarong
A. Ian McLeod
Marnin Heisel
Daniel Hackam
J. David Spence
SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes
description Background: Previous classification systems of acute ischemic stroke (Causative Classification System, CCS, of acute ischemic stroke, Trial of Org 10172 in Acute Stroke Treatment, TOAST) established the diagnosis of large artery disease (LAD) based on the presence or absence of carotid stenosis. However, carotid plaque burden is a stronger predictor of cardiovascular risk than stenosis. Our objective was to update definitions of ischemic stroke subtypes to improve the detection of LAD and to assess the validity and reliability of a new classification system: SPARKLE (Subtypes of Ischaemic Stroke Classification System). Methods: In a retrospective review of clinical research data, we compared three stroke subtype classifications: CCS, TOAST and SPARKLE. We analyzed a random sample of 275 patients presenting with minor stroke or transient ischemic attack (TIA) in an Urgent TIA Clinic in London, Ont., Canada, between 2002 and 2012. Results: There was substantial overall agreement between SPARKLE and CCS (κ = 0.75), with significant differences in the rate of detection of LAD, cardioembolic and undetermined causes of stroke or TIA. The inter-rater reliability of SPARKLE was substantial (κ = 0.76) and the intra-rater reliability was excellent (κ = 0.91). Conclusion: SPARKLE is a valid and reliable classification system, providing advantages compared to CCS and TOAST. The incorporation of plaque burden into the classification of LAD increases the proportion of cases attributable to LAD and reduces the proportion classified as being of 'undetermined' etiology. © 2014 S. Karger AG, Basel.
author2 Robarts Research Institute
author_facet Robarts Research Institute
Chrysi Bogiatzi
Thapat Wannarong
A. Ian McLeod
Marnin Heisel
Daniel Hackam
J. David Spence
format Article
author Chrysi Bogiatzi
Thapat Wannarong
A. Ian McLeod
Marnin Heisel
Daniel Hackam
J. David Spence
author_sort Chrysi Bogiatzi
title SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes
title_short SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes
title_full SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes
title_fullStr SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes
title_full_unstemmed SPARKLE (Subtypes of ischaemic stroke classification system), Incorporating measurement of carotid plaque burden: A new validated tool for the classification of ischemic stroke subtypes
title_sort sparkle (subtypes of ischaemic stroke classification system), incorporating measurement of carotid plaque burden: a new validated tool for the classification of ischemic stroke subtypes
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/34618
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