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Published on: August 28, 2018

Association of ischemic stroke to coronary artery disease using computed tomography coronary angiography

Jesper K Jensen1, Hector M Medina, Bjarne L Nørgaard

  • 1Department of Cardiology, Vejle Hospital, Denmark. jesperkjensen@dadlnet.dk

International Journal of Cardiology
|May 6, 2011
PubMed

Insights

Acute ischemic stroke (IS) is independently linked to a higher risk and greater extent of coronary artery disease (CAD). This suggests IS may indicate significant underlying CAD in patients presenting with chest pain.

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Coronary artery disease (CAD) and cerebrovascular disease share risk factors, but IS as a CAD equivalent is understudied.
  • Cardiac computed tomography angiography (CTA) is utilized to assess coronary artery plaque burden.

Purpose of the Study:

  • To determine if ischemic stroke (IS) is an independent predictor of coronary artery disease (CAD).
  • To evaluate the association between acute IS and the presence and extent of coronary artery plaque.

Main Methods:

  • Analysis of cardiac CTA in 392 patients without prior CAD.
  • Comparison between 24 patients with acute IS and 368 patients with acute chest pain.
  • Dichotomization of plaque burden into 0-4 versus >4 coronary segments.

Main Results:

  • Patients with IS showed a nearly 5-fold increased odds of having coronary artery plaque (OR 4.9).
  • Adjusted analysis revealed a nearly 4-fold increased odds for coronary plaque (aOR 3.7).
  • IS patients had over 18-fold increased odds for extensive plaque (>4 segments), remaining significant after adjustment (aOR 12.1).

Conclusions:

  • Acute ischemic stroke is independently associated with a higher risk of CAD.
  • Acute IS correlates with a greater extent of coronary artery plaque burden.
  • IS may serve as an indicator of significant CAD in patients presenting with low-to-intermediate risk acute coronary syndrome symptoms.
Abstract

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