Document Detail


Clinical utility of evaluating intracranial artery stenosis and silent brain infarction to predict the presence of subclinical coronary artery disease in ischemic stroke patients.
MedLine Citation:
PMID:  18854628     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We have recently reported the prevalence of subclinical cardiovascular diseases and the association between the presence of subclinical coronary artery disease (CAD) and vascular risk factors in ischemic stroke patients. The relationship between the presence of subclinical CAD and elements of brain ischemia including intracranial artery stenosis, silent brain infarction (SBI), and white matter lesions remains unclear. We determined the usefulness of elements of brain ischemia to predict the presence of subclinical CAD in ischemic stroke patients. METHODS: The study group comprised 100 patients with first-ever ischemic stroke who had no history of CAD. Intracranial artery stenosis on magnetic resonance angiography and SBI and white matter lesions on magnetic resonance imaging were investigated in comparison with CAD defined as > or =50% stenosis on coronary computed tomographic angiography. RESULTS: Thirty-six patients had subclinical CAD. Intracranial artery stenosis (78.1% vs 35.1%, p<0.0001) and SBI (69.4% vs 46.9%, p=0.03) were more prevalent in patients with subclinical CAD. Of the patients with both intracranial artery stenosis and SBI, 61% had subclinical CAD. Multiple regression analyses showed that the presence of subclinical CAD was independently associated with intracranial artery stenosis; <50% stenosis (OR 8.01 95%CI 2.02 to 31.9; p<0.01), > or =50% stenosis (OR 19.5 95%CI 2.77 to 137.4; p<0.01), and multiple SBI (OR 3.85 95%CI 1.23 to 12.0; p<0.05). CONCLUSION: The evaluation of intracranial artery stenosis and SBI may be useful to identify ischemic stroke patients at high risk for subclinical CAD.
Authors:
Atsushi Hoshino; Takashi Nakamura; Satoko Enomoto; Hiroyuki Kawahito; Hiroyuki Kurata; Yoshifumi Nakahara; Toshiharu Ijichi
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Publication Detail:
Type:  Journal Article     Date:  2008-10-15
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  47     ISSN:  1349-7235     ISO Abbreviation:  Intern. Med.     Publication Date:  2008  
Date Detail:
Created Date:  2008-10-15     Completed Date:  2009-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1775-81     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto. a-hoshi@koto.kpu-m.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain Infarction / pathology*
Constriction, Pathologic / pathology
Coronary Angiography
Coronary Artery Disease / diagnosis*,  epidemiology*
Cross-Sectional Studies
Female
Humans
Intracranial Arterial Diseases / pathology*
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Mass Screening
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prevalence
Retrospective Studies
Risk Factors
Severity of Illness Index
Stroke / complications*

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