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Clinical Summary

Prevalence of coronary artery disease in patients with ischaemic stroke

Takeaway

  • Coronary artery disease (CAD) was prevalent in patients with ischaemic stroke (IS).
  • No conclusive association was observed between CAD and intracranial or extracranial large artery cerebrovascular disease (LAD).

Why this matters

  • Long-term follow-up of patients with stroke suggest that cardiac events account for a high proportionate mortality.
  • Published data suggest that 2%-5% of IS patients have fatal cardiac events within 90 days of stroke occurrence as they may harbour a clinically asymptomatic CAD.

Study design

  • This prospective observational study included 300 patients with IS and transient ischaemic attack (TIA).
  • Patients underwent myocardial Stress-rest Gated Technetium-99m (Tc99m) MIBI Myocardial Perfusion single-photon emission computed tomography (MPSPECT) scan performed on a dual head SPECT-CT.
  • Funding: The Indian Council of Medical Research.

Key results

  • Out of 300 patients, 41 were previously diagnosed with definitive CAD, 12 were clinically suspected to have CAD and 247 patients were asymptomatic.
  • Among the clinically asymptomatic patients, 12 patients (4.81%) had a positive single-photon emission computed tomography suggestive of CAD.
  • The overall prevalence of CAD was 17.67% and diabetes was an independent predictor of CAD (OR, 1.98; 95% CI, 1.07-3.67; P=.02).
  • LAD was not significantly associated with CAD in all subgroup comparisons and there was a suggestion of higher LAD in patients with known CAD vs others.

Limitations

  • All patients did not complete the study.
  • Patients at different time points from the onset of IS were included.

References


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