Prevalence of coronary artery disease in patients with ischaemic stroke

  • Bhatia R & al.
  • J Stroke Cerebrovasc Dis
  • 9 Oct 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

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.