More coronary artery stenosis, more cerebral artery stenosis? A simultaneous angiographic study discloses their
Ai-Hsien Li1, Yiu-Tong Chu, Lin-Hsue Yang
1Cardiovascular Center, Far Eastern Memorial Hospital, Banchao, Taipei, Taiwan. las1012.tw@yahoo.com.tw
Insights
Cerebral artery stenosis (CAS) frequently coexists with coronary artery disease (CAD). More than half of CAD patients studied had CAS, with severity correlating to coronary artery disease extent.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Vascular Medicine
Background:
- Cerebral artery stenosis (CAS) shares pathogenesis with coronary artery disease (CAD).
- Coexistence of CAS and CAD is infrequently reported.
- Understanding this association is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the prevalence of coexistent CAS in patients diagnosed with CAD.
- To analyze the relationship between cerebral and coronary artery stenosis severity.
- To identify potential risk factors associated with cerebral stenosis in CAD patients.
Main Methods:
- Simultaneous coronary and cerebral angiography performed in 80 newly diagnosed CAD patients.
- Significant stenosis defined as >50% diameter reduction.
- Analysis of demographic parameters and correlation between stenotic lesion counts.
Main Results:
- Over half of the studied CAD patients exhibited significant CAS (intracranial, extracranial, or both).
- A strong correlation was found between the number of coronary stenotic vessels and cerebral stenotic lesions (r = 0.562, P < 0.001).
- Hypertension and diabetes did not show significant differences between groups, unlike coronary artery disease severity.
Conclusions:
- CAS is highly prevalent in patients with CAD, affecting over half of the cohort.
- The severity of CAS is proportionally related to the severity of CAD.
- This finding suggests a common underlying pathophysiology and emphasizes the need for screening CAS in CAD patients.
Abstract:
Cerebral artery stenosis (CAS) has the same pathogenesis as coronary artery disease (CAD), but the coexistence of these two diseases has been rarely reported. To detect coexistent CAS in CAD patients, we conducted a study of simultaneous coronary and cerebral angiography. Of the 663 consecutive newly diagnosed CAD patients who had not yet been explored to have CAS, 80 were admitted to undergo angiography of bilateral carotid and vertebral system during the same procedure. We defined significant vascular stenosis, either located intracranially or extracranially, as the lesions of diameter stenosis more than 50%. Association between carotid or vertebral stenosis and their potential risk factors were also analyzed. Of our patients, 18 (22.5%) had significant extracranial vascular stenosis, 14 (17.5%) suffered from intracranial stenosis, and 20 (25%) had both. Only 28 patients (35%) had no significant intracranial or extracranial stenosis. None of the demographic parameters as hypertension or diabetes showed significant differences between the cerebral patent group and the CAS group, except for the number of coronary stenotic vessels (1.71 +/- 0.81 versus 2.69 +/- 0.64, P < 0.001). The number of coronary stenotic vessels is correlated well to the number of cerebral stenotic lesions (r = 0.562, P < 0.001). Besides, 8 of the cerebral stenotic patients and 2 of the cerebral patent patients had ischemic stroke previously. We conclude the CAS is coexistent in more than half of the CAD patients in this study. Our study also implies a proportional increase in the severity of CAS to CAD severity.
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