The PLANS model predicts recurrent strokes in patients with minor ischemic strokes

Abstract Minor ischemic stroke (MIS) patients face significant risks of recurrent strokes, necessitating reliable predictive tools. This single-center retrospective study developed and validated a novel model for predicting 1-year stroke recurrence in MIS patients, defined as those with National Ins...

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Main Authors: Zhi-Xin Huang, Haike Lu, Yi Lu, Yingyi Dai, Jianguo Lin, Zhenguo Liu
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-93741-8
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author Zhi-Xin Huang
Haike Lu
Yi Lu
Yingyi Dai
Jianguo Lin
Zhenguo Liu
author_facet Zhi-Xin Huang
Haike Lu
Yi Lu
Yingyi Dai
Jianguo Lin
Zhenguo Liu
author_sort Zhi-Xin Huang
collection DOAJ
description Abstract Minor ischemic stroke (MIS) patients face significant risks of recurrent strokes, necessitating reliable predictive tools. This single-center retrospective study developed and validated a novel model for predicting 1-year stroke recurrence in MIS patients, defined as those with National Institutes of Health Stroke Scale scores < 4 within seven days of symptom onset. Among 218 patients (median age 64 years, 26.6% female), 32 (14.7%) experienced recurrent strokes within one year. Analysis of clinical and lifestyle variables identified physical activity, large artery stroke, admission NIHSS score, and smoking as significant predictors, forming the PLANS model. The model demonstrated superior predictive performance compared to the Essen model, with a higher C-index (0.780 vs. 0.556) and better calibration. Risk reclassification metrics showed significant improvements, with integrated discrimination improvement of 20.3%, continuous net reclassification improvement of 41.7%, and median risk score improvement of 18.5%. The PLANS model, incorporating both traditional and novel risk factors, provides a valuable tool for patient stratification and personalized secondary prevention strategies. External validation in diverse cohorts is warranted to confirm these promising results.
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spelling doaj-art-a9db965b7f0f48cd99814a4ac012e1fa2025-08-20T02:52:16ZengNature PortfolioScientific Reports2045-23222025-03-0115111010.1038/s41598-025-93741-8The PLANS model predicts recurrent strokes in patients with minor ischemic strokesZhi-Xin Huang0Haike Lu1Yi Lu2Yingyi Dai3Jianguo Lin4Zhenguo Liu5NeuroMedical Center, The Affiliated Guangdong Second Provincial General Hospital of Jinan UniversityNeuroMedical Center, The Affiliated Guangdong Second Provincial General Hospital of Jinan UniversityInterventional Vascular Surgery Department, Guangdong Second Provincial General HospitalNeuroMedical Center, The Affiliated Guangdong Second Provincial General Hospital of Jinan UniversityDepartment of Pediatrics, Washington University in Saint LouisCenter for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of MedicineAbstract Minor ischemic stroke (MIS) patients face significant risks of recurrent strokes, necessitating reliable predictive tools. This single-center retrospective study developed and validated a novel model for predicting 1-year stroke recurrence in MIS patients, defined as those with National Institutes of Health Stroke Scale scores < 4 within seven days of symptom onset. Among 218 patients (median age 64 years, 26.6% female), 32 (14.7%) experienced recurrent strokes within one year. Analysis of clinical and lifestyle variables identified physical activity, large artery stroke, admission NIHSS score, and smoking as significant predictors, forming the PLANS model. The model demonstrated superior predictive performance compared to the Essen model, with a higher C-index (0.780 vs. 0.556) and better calibration. Risk reclassification metrics showed significant improvements, with integrated discrimination improvement of 20.3%, continuous net reclassification improvement of 41.7%, and median risk score improvement of 18.5%. The PLANS model, incorporating both traditional and novel risk factors, provides a valuable tool for patient stratification and personalized secondary prevention strategies. External validation in diverse cohorts is warranted to confirm these promising results.https://doi.org/10.1038/s41598-025-93741-8LifestyleMinor strokeRecurrent strokeStroke
spellingShingle Zhi-Xin Huang
Haike Lu
Yi Lu
Yingyi Dai
Jianguo Lin
Zhenguo Liu
The PLANS model predicts recurrent strokes in patients with minor ischemic strokes
Scientific Reports
Lifestyle
Minor stroke
Recurrent stroke
Stroke
title The PLANS model predicts recurrent strokes in patients with minor ischemic strokes
title_full The PLANS model predicts recurrent strokes in patients with minor ischemic strokes
title_fullStr The PLANS model predicts recurrent strokes in patients with minor ischemic strokes
title_full_unstemmed The PLANS model predicts recurrent strokes in patients with minor ischemic strokes
title_short The PLANS model predicts recurrent strokes in patients with minor ischemic strokes
title_sort plans model predicts recurrent strokes in patients with minor ischemic strokes
topic Lifestyle
Minor stroke
Recurrent stroke
Stroke
url https://doi.org/10.1038/s41598-025-93741-8
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