Association of Coagulation and Inflammation Indicators with ABCD2 Score and Short-Term Prognosis in Patients with Transient Ischemic Attack

HUANG Yi; WANG Lin; FAN Ke; CHEN Li; LIU Hong

doi:10.3639/j.issn.2095-3097.2026.02.012

Abstract：Objective To investigate the relationship of coagulation,inflammation and other indicators with ABCD2 score and short-term prognosis in patients with transient ischemic attack(TIA).Methods A total of 372 patients with TIA admitted to Qionglai Medical Center Hospital from August 2024 to August 2025 were selected.According to the ABCD2 score,they were divided into a low-risk group(145 cases),a medium-risk group(161 cases),and a high-risk group(66 cases).The general clinical data of the three groups of TIA patients were compared.Spearman correlation analysis was used to analyze the correlations between ABCD2 score and D-dimer(D-D),fibrinogen(FIB),chemokine ligand 12(CXCL12),high-sensitivity C-reactive protein(hs-CRP),and homocysteine(Hcy)in TIA patients.Based on whether acute cerebral infarction(ACI)occurred within 7 days,the patients were divided into an ACI group(87 cases)and a non-ACI group(285 cases).The general clinical data between the two groups were compared.Multivariate logistic regression analysis was employed to identify the influencing factors for short-term ACI occurrence in TIA patients.A prediction model was constructed,and receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of each indicator for short-term ACI occurrence in TIA patients.Results The levels of D-D,FIB,CXCL12,hs-CRP,and Hcy in the medium-risk and high-risk groups were higher than those in the low-risk group(P<0.05);the levels of D-D,FIB,CXCL12,hs-CRP,and Hcy in the high-risk group were higher than those in the medium-risk group(P<0.05).Spearman correlation analysis showed that D-D,FIB,CXCL12,hs-CRP,and Hcy were positively correlated with ABCD2 score in TIA patients(r=0.436,0.451,0.508,0.515,0.482,all P<0.001).The ACI group had a higher proportion of diabetes and higher levels of ABCD2 score,D-D,FIB,CXCL12,hs-CRP,and Hcy than the non-ACI group(P<0.05).Multivariate Logistic regression analysis showed that diabetes,ABCD2 score,D-D,FIB,CXCL12,hs-CRP,and Hcy were independent risk factors for short-term ACI in TIA patients(OR=1.564,95%CI:1.044-2.341,P=0.031;OR=1.811,95%CI:1.179-2.782,P=0.007;OR=1.587,95%CI:1.068-2.358,P=0.023;OR=1.496,95%CI:1.148-1.950,P=0.003;OR=1.534,95%CI:1.150-2.046,P=0.004;OR=1.480,95%CI:1.152-1.902,P=0.002;OR=1.618,95%CI:1.080-2.422,P=0.020).A prediction model was constructed based on the multivariate logistic regression results.The Hosmer-Lemeshow goodness-of-fit test showed a good fit for the model(P<0.05).ROC curve analysis showed that the area under the curve of the model was 0.922,with a sensitivity and specificity of 82.80%and 90.90%at the optimal cutoff value.ROC curve analysis showed that the areas under the curve for D-D,FIB,CXCL12,hs-CRP,and Hcy in predicting short-term ACI in TIA patients were 0.846,0.838,0.868,0.896,and 0.730,with sensitivities of 74.70%,78.20%,77.00%,75.90%,and 72.40%,and specificities of 91.90%,77.90%,89.50%,93.70%,and 62.80%,respectively.The area under the curve for combined prediction was 0.926,with a sensitivity of 82.80%and a specificity of 90.90%.The efficacy of combined prediction was superior to that of D-D,FIB,or Hcy alone(Z=-2.062,-3.096,-5.544,P<0.05).Conclusion The levels of D-D,FIB,CXCL12,hs-CRP,and Hcy in TIA patients are related to ACI risk and prognosis.Higher levels of D-D,FIB,CXCL12,hs-CRP,and Hcy are associated with a higher risk of future ACI in TIA patients.Measures should be taken as early as possible to prevent ACI in high-risk patients.