Document Detail

Prevalence of silent myocardial ischemia in single and multiple lacunar infarcts and large vessel disease stroke.
MedLine Citation:
PMID:  20510499     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: The relationships between single (SLI) and multiple lacunar infarcts (MLI) and occult coronary artery disease (CAD) have not yet been sufficiently evaluated. We aimed to investigate the prevalence of silent CAD in patients with SLI, MLI and large vessel disease (LVD) stroke, and to identify factors associated with its presence.
METHODS: We enrolled 125 patients who had suffered their first non-cardioembolic ischemic stroke but had no documented history of CAD. According to their pathologies, these patients were assigned to one of three groups: MLI (n=21), SLI (n=50) or LVD (n=54). Asymptomatic CAD was detected by myocardial perfusion SPECT imaging.
RESULTS: Silent CAD was detected in 40 patients (32% of the total); of those that experienced CAD, 15 (30%) were from the SLI group, 7 (33%) had MLI, and 18 (33%) had an LVD stroke. Differences between the groups were not significant. During a median follow-up of 48 months, the overall stroke recurrence was 8.8%; the stroke recurrence rates for each subgroup were 6% in patients with SLI, 7% in LVD and 19% in MLI. Mortality was higher in patients from the MLI and LVD groups (26% and 14%, respectively) than in those from the SLI group (6%; p=0.02). We found no relationships between the various risk factors and silent CAD.
CONCLUSIONS: In this exploratory study, SPECT imaging results revealed that the prevalence of abnormal myocardial perfusion was similar in patients with either single or multiple lacunar infarcts and those that had experienced large vessel disease stroke.
Antonio Arauz; Juan Calleja; Enrique Vallejo; Lisveth Quintero
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-05-26
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  112     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  658-61     Citation Subset:  IM    
Copyright Information:
(c) 2010 Elsevier B.V. All rights reserved.
Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
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MeSH Terms
Aged, 80 and over
Atherosclerosis / classification,  complications*,  radionuclide imaging
Blood Vessels / pathology
Brain Infarction / classification,  complications*
Dipyridamole / diagnostic use
Exercise Test
Middle Aged
Myocardial Ischemia / complications,  diagnosis*,  radionuclide imaging
Myocardial Perfusion Imaging
Organ Size
Prospective Studies
Radiopharmaceuticals / diagnostic use
Risk Factors
Stroke / classification*,  complications,  pathology
Tomography, Emission-Computed, Single-Photon
Reg. No./Substance:
0/Radiopharmaceuticals; 58-32-2/Dipyridamole

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