Document Detail


Frequency and severity of asymptomatic coronary disease in patients with different causes of stroke.
MedLine Citation:
PMID:  9158629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: We sought (1) to compare the frequency and severity of asymptomatic coronary artery disease (CAD) in patients with different causes of brain ischemia and (2) to determine profiles of patients with brain ischemia who are at highest risk of asymptomatic CAD. METHODS: Sixty-nine patients with transient ischemic attack or stroke and without overt CAD underwent a cardiac stress test and a diagnostic evaluation to determine the cause of brain ischemia. The frequency of abnormal cardiac stress tests was compared in patients with large-artery cerebrovascular disease versus other causes of brain ischemia (90% of whom had penetrating artery disease or cryptogenic stroke). Additionally, the frequencies of vascular risk factors, resting electrocardiographic abnormalities, and cause of stroke (large-artery disease versus other causes) were compared in patients with abnormal stress tests versus patients with normal stress tests. RESULTS: The frequency of abnormal stress tests was 50% (15 of 30) in patients with large-artery cerebrovascular disease versus 23% (9 of 39) in patients with other causes of brain ischemia (P = .04). Moreover, 60% of abnormal stress tests (9 of 15) in patients with large-artery cerebrovascular disease suggested severe underlying CAD that was confirmed in 7 of 7 patients who underwent coronary angiography. On the other hand, less than 25% of abnormal stress tests (2 of 9) in patients with other causes of brain ischemia suggested severe underlying CAD. Features that were more common in patients with abnormal stress tests were smoking (P = .006), large-artery cerebrovascular disease (P = .02), veteran status (P = .02), and left ventricular hypertrophy (P = .07). CONCLUSIONS: Patients with penetrating artery disease or cryptogenic stroke have a significantly lower frequency of asymptomatic CAD than patients with large-artery cerebrovascular disease. Large-artery cerebrovascular disease, smoking, veteran status, and possibly left ventricular hypertrophy may be useful features for identifying patients with transient ischemic attack or stroke who are at highest risk of harboring asymptomatic CAD.
Authors:
M I Chimowitz; R M Poole; M R Starling; M Schwaiger; M D Gross
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  28     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-23     Completed Date:  1997-06-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  941-5     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Michigan Medical Center, Ann Arbor, USA. mchimo@neuro.emory.edu
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MeSH Terms
Descriptor/Qualifier:
Brain Ischemia / complications,  etiology,  physiopathology
Cerebrovascular Disorders / complications*,  diagnosis,  etiology
Coronary Angiography
Coronary Circulation
Coronary Disease / complications*,  physiopathology
Exercise Test
Female
Humans
Male
Middle Aged
Observer Variation
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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