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Cardiovascular disease in male patients with carotid transient ischemic attacks or minor strokes
P Falke1, L Stavenow, F Hansen
1Department of Internal Medicine, University of Lund, Malmö General Hospital, Sweden.
Insights
Patients with transient ischemic attacks (TIA) show higher rates of myocardial infarction and cardiac dilatation than minor stroke patients. However, atherosclerosis in the carotid or lower extremities did not differ between groups.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Transient ischemic attacks (TIA) and minor strokes share risk factors but may present different underlying pathologies.
- Understanding the prevalence of coronary heart disease and atherosclerosis in these patient groups is crucial for risk stratification.
Purpose of the Study:
- To investigate the hypothesis that coronary heart disease and lower extremity atherosclerosis are more frequent in patients with TIA compared to those with minor stroke.
- To compare cardiac and arterial findings between TIA and minor stroke patients.
Main Methods:
- A comparative study involving 33 TIA patients and 36 minor stroke patients from the carotid artery territory.
- Utilized ultrasonography, echocardiography (UCG), electrocardiogram (ECG), thallium scintigraphy (TS), and ankle/arm index (A/AI) assessment.
- Evaluated cardiac function, myocardial infarction, and stenosis in cardiac, iliac, and femoral arteries.
Main Results:
- Thallium scintigraphy revealed significantly more myocardial infarctions in TIA patients (54%) versus minor stroke patients (19%).
- Echocardiography showed higher frequencies of left ventricular and atrial dilatation in the TIA group (64%) compared to the minor stroke group (27%).
- No significant differences were found in the frequency of significant carotid artery stenosis (≥50%) or ankle/arm index between the two groups.
Conclusions:
- TIA patients exhibit a greater incidence of myocardial infarction and cardiac dilatation than minor stroke patients.
- The degree of atherosclerosis in the carotid or lower extremity arteries did not differ significantly between TIA and minor stroke patients.
- Findings suggest TIA may be associated with a higher burden of cardiac pathology independent of significant peripheral arterial disease.
Abstract:
The authors tested the hypothesis that coronary heart disease and lower extremity atherosclerosis occur more frequently in patients with transient ischemic attacks (TIA) than in patients with minor stroke. Thirty-three consecutive male patients with TIA and 36 with minor stroke from the carotid artery territory were examined with ultrasonography of the cardiac, iliac, and femoral arteries; echocardiography (UCG); electrocardiogram (ECG); thallium scintigraphy (TS) of the myocardium; and assessment of the ankle/arm index (A/AI). TS showed myocardial infarctions to be more common among TIA patients than among minor stroke patients, 54% vs 19%, p = 0.019. UCG showed the frequency of left ventricular and atrial dilatation to be higher in the TIA group than in the minor stroke group, 64% vs 27%, p = 0.0084. Significant artery stenosis (greater than or equal to 50%) was not, however, more frequent in the TIA group than in the minor stroke group, nor was there any significant difference between the groups in A/AI. The frequency of TS-verified myocardial infarction (MI) was higher in the subgroup with greater than or equal to 50% carotid artery stenosis than in that with less than 50% stenosis, 61% vs 25%, p = 0.022, and also higher in the pathological UCG subgroup than in the normal UCG subgroup, 50% vs 15%, p = 0.025. Thus, there was a greater incidence both of TS-verified MI and of UCG-verified cardiac dilatation in the TIA group than in the minor stroke group but no difference between the groups in the degree of atherosclerosis either in the carotid or lower extremity regions.(ABSTRACT TRUNCATED AT 250 WORDS)