{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:10:14Z","timestamp":1780528214728,"version":"3.54.1"},"reference-count":43,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PB-PG-1112-29069"],"award-info":[{"award-number":["PB-PG-1112-29069"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,6,25]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Transient ischaemic attacks (TIA) and minor strokes are important risk factors for further vascular events. We explored the role of albumin creatinine ratio (ACR) in improving risk prediction after a first event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Rapid access stroke clinics in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>2202 patients attending with TIA or minor stroke diagnosed by the attending stroke physician, able to provide a urine sample to evaluate ACR using a near-patient testing device.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>Primary outcome was major adverse cardiac events (MACE: recurrent stroke, myocardial infarction or cardiovascular death) at 90 days. The key secondary outcome was to determine whether urinary ACR could contribute to a risk prediction tool for use in a clinic setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>151 MACE occurred in 144 participants within 90 days. Participants with MACE had higher ACR than those without. A composite score awarding a point each for age &gt;80 years, previous stroke\/TIA and presence of microalbuminuria identified those at low risk and high risk. 90% of patients were at low risk (scoring 0 or 1). Their 90-day risk of MACE was 5.7%. Of the remaining \u2018high-risk\u2019 population (scoring 2 or 3) 12.4% experienced MACE over 90 days (p&lt;0.001 compared with the low-risk population). The need for acute admission in the first 7\u2009days was twofold elevated in the high-risk group compared with the low-risk group (3.23% vs 1.43%; p=0.05). These findings were validated in an independent historic sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A risk score comprising age, previous stroke\/TIA and microalbuminuria predicts future MACE while identifying those at low risk of a recurrent event. This tool shows promise in the risk stratification of patients to avoid the admission of low-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-043253","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T12:34:05Z","timestamp":1630931645000},"page":"e043253","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of microalbuminuria as a prognostic indicator after a TIA or minor stroke in an outpatient setting: the prognostic role of microalbuminuria in TIA evolution (ProMOTE) study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6826-418X","authenticated-orcid":false,"given":"W David","family":"Strain","sequence":"first","affiliation":[{"name":"Diabetes and Vascular Research Centre, University of Exeter, Exeter, Devon, UK"},{"name":"Academic Department of Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK"},{"name":"NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Elyas","sequence":"additional","affiliation":[{"name":"Diabetes and Vascular Research Centre, University of Exeter, Exeter, Devon, UK"},{"name":"Academic Department of Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Wedge","sequence":"additional","affiliation":[{"name":"Academic Department of Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK"},{"name":"NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6089-0661","authenticated-orcid":false,"given":"Luke","family":"Mounce","sequence":"additional","affiliation":[{"name":"Institute of Health Research, University of Exeter Medical School, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Henley","sequence":"additional","affiliation":[{"name":"Institute of Health Research, University of Exeter Medical School, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"James","sequence":"additional","affiliation":[{"name":"Academic Department of Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela C","family":"Shore","sequence":"additional","affiliation":[{"name":"Diabetes and Vascular Research Centre, University of Exeter, Exeter, Devon, UK"},{"name":"NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,9,6]]},"reference":[{"key":"2025121403340074000_11.9.e043253.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308413"},{"key":"2025121403340074000_11.9.e043253.2","unstructured":"Henssge U . National sentinel stroke clinical audit 2010. 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