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Heart and carotid artery disease in stroke patients with intermittent claudication
X F Liu1, G van Melle, J Bogousslavsky
1Department of Neurology, Centre Hospitalier Universitaire Vaudois, and University Institute of Social and Preventive Medicine, Lausanne, Switzerland.
Insights
Intermittent claudication (IC) in stroke patients is linked to more severe atherosclerosis. These patients often have heart disease, carotid artery disease, and other risk factors, suggesting widespread vascular disease.
Area of Science:
- Vascular Neurology
- Cardiology
- Epidemiology
Background:
- Intermittent claudication (IC) is a common condition, but its clinical features in stroke patients are not well understood.
- Stroke patients with IC may represent a subset with more generalized atherosclerotic disease.
Purpose of the Study:
- To investigate the clinical features and risk factors associated with intermittent claudication (IC) in a stroke patient population.
- To compare stroke patients with and without IC regarding comorbidities like heart disease and carotid artery disease.
Main Methods:
- A hospital-based study of 3901 stroke patients prospectively entered into a databank.
- An age-matched random sample of 219 IC cases and 2628 non-IC cases was analyzed.
- Prevalence of IC and associated risk factors were assessed across age groups.
Main Results:
- The prevalence of IC in the stroke population was 5.6%, increasing with age until approximately 70 years.
- Cardiac ischemia and internal carotid artery (ICA) disease were significantly more frequent in stroke patients with IC.
- IC patients showed higher prevalence of atherosclerosis, smoking, hypercholesterolemia, elevated hematocrit, and family history of stroke.
Conclusions:
- Ischemic heart disease and ICA disease are particularly common in stroke patients with IC.
- IC, large artery disease, and stroke share common risk factors, indicating generalized atherosclerosis.
- The presence of IC symptoms in stroke patients may signify extensive, systemic atherosclerotic disease.
Abstract:
Much has been published on the natural history of intermittent claudication (IC), but little is known about the clinical features of stroke patients with IC. The purpose of this study was to examine clinical features and risk factors in stroke patients with or without IC, including heart disease and carotid artery disease. A hospital-based study was conducted of 3901 stroke patients, who were prospectively coded and entered into a computerized databank. Of these patients, 219 had symptoms of IC. Patients were subdivided by age into 10-year categories. There were at least 12 times more non-IC than IC patients in each category. An age-matched random sample was obtained containing 12 non-IC cases for each IC case, resulting in 219 cases of IC and 2628 non-IC cases. The prevalence of IC in the total stroke population was 5.6%. IC prevalence increased sharply with age until about 70 years. Cardiac ischaemia and internal carotid artery (ICA) disease were significantly more frequent in stroke with IC than without IC. IC patients also exhibited a higher prevalence of atherosclerotic disease as well as other risk factors such as smoking, hypercholesterolaemia, elevated haematocrit, and family history of stroke. Ischaemic heart disease and ICA disease are especially common in stroke with IC. IC, large artery disease and stroke share similar risk factors. IC symptoms in stroke patients may indicate extensive generalized atherosclerosis.