Document Detail

Prevalence of coronary atherosclerosis in patients with cerebral infarction.
MedLine Citation:
PMID:  21088246     Owner:  NLM     Status:  MEDLINE    
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 ≥ 50% 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.
Pierre Amarenco; Philippa C Lavallée; Julien Labreuche; Gregory Ducrocq; Jean-Michel Juliard; Laurent Feldman; Lucie Cabrejo; Elena Meseguer; Celine Guidoux; Valérie Adraï; Samina Ratani; Jérôme Kusmierek; Bertrand Lapergue; Isabelle F Klein; Fernando Gongora-Rivera; Arturo Jaramillo; Mikael Mazighi; Pierre-Jean Touboul; Philippe Gabriel Steg
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-11-18
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-28     Completed Date:  2011-01-28     Revised Date:  2011-08-16    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-9     Citation Subset:  IM    
INSERM U-698 and Paris-Diderot University, Paris, France.
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MeSH Terms
Carotid Arteries / radiography
Cerebral Infarction / complications,  epidemiology*,  radiography*
Coronary Angiography*
Coronary Disease / complications,  epidemiology*,  radiography*
Coronary Stenosis / complications,  epidemiology,  radiography
Femoral Artery / radiography
Middle Aged
Comment In:
Stroke. 2011 Jul;42(7):e406; author reply e407   [PMID:  21597021 ]

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

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