Coronary artery disease and cardiac events with asymptomatic and symptomatic cerebrovascular disease.

Love, Betsy B.; Grover‐McKay, Maleah; Biller, José; Rezai, Karim; McKay, Charles R.

doi:10.1161/01.str.23.7.939

Cited by 65 publications

(31 citation statements)

References 37 publications

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“…Previous studies were based on exercise electrocardiograms or myocardial scintigraphy in patients with stroke or transient ischemic attack. [11][12][13][14][15][16][17][18][19][20][21][22] These small series suggested a prevalence of silent myocardial ischemia as high as 40%. In the present study, which, to our knowledge, is the largest ever using gold standard coronary angiography in nonfatal ischemic strokes, the 62% prevalence of coronary artery plaque and the 26% prevalence of coronary artery stenosis Ն50% was consistent with the 70% prevalence and 29% prevalence, respectively, found in a previous autopsy series of fatal stroke without coronary heart disease history.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Coronary Atherosclerosis in Patients With Cerebral Infarction

Amarenco

Lavallée

Labreuche

et al. 2011

Stroke

155

122

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Background and Purpose-There is an overlap between stroke and coronary heart disease, but the exact prevalence of coronary artery disease in patients with nonfatal cerebral infarction is unclear, particularly when there is no known history of coronary heart disease. Methods-We consecutively enrolled 405 patients presenting with acute cerebral infarction documented by neuroimaging who underwent carotid and femoral artery, thoracic, and abdominal aorta ultrasound examinations.Of the 342 patients with no known coronary heart disease, 315 underwent coronary angiography a median of 8 days (interquartile range, 6 -11) after stroke onset. Results-Coronary plaques on angiography, regardless of stenosis severity, were present in 61.9% of patients (95% confidence interval [CI], 56.5-67.3) and coronary stenoses Ն50% were found in 25.7% (95% CI, 20.9 -30.5). The overall prevalence of coronary plaque increased with the number of arterial territories (carotid or femoral arteries) involved, with an adjusted odds ratio of coronary artery disease of 1.25 (95% CI, 0.58 -2.71) for presence of plaque in 1 territory, and 4.31 (95% CI, 1.92-9.68) for presence of plaque in both territories, compared with no plaque in either territory. The presence of plaque in both femoral and carotid arteries had an age-and sex-adjusted positive predictive value of 84% for presence of coronary plaque and a negative predictive value of 44%. Conclusions-There is a high burden of silent coronary artery disease in patients with nonfatal cerebral infarction and no known coronary heart disease, even in the absence of systemic atherosclerosis. The prevalence is even higher in patients with evidence of carotid and/or femoral plaque. (Stroke. 2011;42:22-29.)

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Section: Discussionmentioning

confidence: 99%

Prevalence of Coronary Atherosclerosis in Patients With Cerebral Infarction

Amarenco

Lavallée

Labreuche

et al. 2011

Stroke

155

122

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“…A history of stroke, transient ischemic attack and peripheral artery disease are associated to CAD and its wider-reaching extension 14,15 . Those clinical conditions affect chronic CAD patients negatively 16 .…”

Section: Discussionmentioning

confidence: 99%

Escore de risco Dante Pazzanese para síndrome coronariana aguda sem supradesnivelamento do segmento ST

Santos¹,

Timerman

Baltar

et al. 2009

Arq. Bras. Cardiol.

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“…Follow-up exercise thallium myocardial scintigraphy was abnormal in 33 of 36 patients, of whom 26 had reversible and 7 had fixed perfusion deficits. Love et al 9 performed Tl-201 myocardial scintigraphy in 27 patients with asymptomatic carotid disease, TIA, or small stroke and no symptoms of CHD. Nine patients (33%) had perfusion defects (reversible in 7 patients, fixed in 1 patient, and both in 1 patient).…”

Section: Prevalence Of Asymptomatic Chd In Patientsmentioning

confidence: 99%

Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke

Adams¹,

Chimowitz²,

Alpert³

et al. 2003

Circulation

226

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Stroke and myocardial infarction (MI) share common risk factors and pathological mechanisms, and coronary artery disease (CHD) is an important cause of death in patients with cerebrovascular disease. This Scientific Statement addresses issues in management of the relatively healthy patient with brain ischemia (a transient ischemic attack [TIA] or an ischemic stroke) who does not have recognized CHD but often has risk factors in addition to having had a TIA or stroke that indicate an increased likelihood of disability or death from cardiac disease in the future. This Statement should not be confused with the official American College of Cardiology (ACC)/American Heart Association (AHA) practice guidelines. The reader is referred to the ACC/AHA guidelines for management of recognized and symptomatic CHD 1 and the American College of Chest Physicians (ACCP) 2 and American Stroke Association (ASA) 3-5 guidelines for evaluation of cardiac causes of TIA and stroke, which are important related but separate issues.

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Coronary artery disease and cardiac events with asymptomatic and symptomatic cerebrovascular disease.

Cited by 65 publications

References 37 publications

Prevalence of Coronary Atherosclerosis in Patients With Cerebral Infarction

Prevalence of Coronary Atherosclerosis in Patients With Cerebral Infarction

Escore de risco Dante Pazzanese para síndrome coronariana aguda sem supradesnivelamento do segmento ST

Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke

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