Poor long-term outcomes in stroke patients with asymptomatic coronary artery disease in heart CT
- Joonsang Yoo; Dongbeom Song; Jang-Hyun Baek; Kyoungsub Kim; Jinkwon Kim; Tae-Jin Song; Hye Sun Lee; Donghoon Choi; Young Dae Kim; Hyo Suk Nam; Ji Hoe Heo
- Dept. of Neurology (신경과학)
- Issue Date
- Atherosclerosis, Vol.265() : 7-13, 2017
- BACKGROUND AND AIMS:
Although stroke patients have a high risk of ischemic heart disease, little information is available on the risk of coronary events in stroke patients with asymptomatic coronary artery disease (CAD). We investigated the long-term vascular outcomes in stroke patients with asymptomatic CAD diagnosed with multi-detector coronary computed tomography (MDCT).
This study was a retrospective analysis using a prospective cohort of ischemic stroke patients. We included consecutive stroke patients without history or symptoms of CAD who underwent MDCT. We investigated the long-term risk of major adverse cardiovascular events (MACE: cardiovascular mortality, ischemic stroke, myocardial infarction, unstable angina, and urgent coronary revascularization) and composite of MACE/all-cause mortality/elective coronary revascularization. We further investigated the value of MDCT for MACE prediction.
Among the 1893 included patients, 1349 (71.3%) patients had some degree of CAD and 654 patients (34.5%) had significant (≥50%) CAD. At follow-up (median, 4.4 years), MACE occurred in 230 patients (12.2%). Event rates of MACE increased with the increasing extent of CAD. After adjustment for age, sex, and risk factors, the hazard ratios for MACE in mild CAD, 1-VD, 2-VD, and 3-VD or left main coronary disease were 1.28 (95% confidence interval [CI]: 0.88-1.87), 1.39 (95% CI: 0.90-2.16), 2.22 (95% CI: 1.39-3.55), and 2.91 (95% CI: 1.82-4.65), respectively (no CAD as a reference). Diagnosis of asymptomatic CAD significantly improved the prediction of MACE.
Asymptomatic CAD detected on MDCT was associated with increased risks of vascular events or deaths in acute stroke patients.
- Ischemic stroke
Coronary artery disease; Major adverse cardiac event; Mortality; Multidetector computerized tomography
- Appears in Collections:
- 1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
- Keimyung Author(s)
- Full Text
- File in this Item
- RIS (EndNote)
- XLS (Excel)