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Severity of coronary atherosclerosis and stroke incidence in 7-year follow-up

Wojciech Sobiczewski1, Marcin Wirtwein, Ewelina Trybala

  • 1I Department of Cardiology, Medical University of Gdansk, Debinki, 780-211 Gdansk, Poland.

Journal of Neurology
|March 21, 2013
PubMed

Insights

Symptomatic patients with multi-vessel coronary artery disease (CAD) face a higher stroke risk. This study found multi-vessel CAD significantly increases stroke hazard in individuals without atrial fibrillation.

Area of Science:

  • Cardiology
  • Neurology
  • Epidemiology

Background:

  • Coronary artery disease (CAD) is a leading cause of mortality and morbidity.
  • Stroke is a major complication, but its association with CAD severity requires further investigation.
  • Atrial fibrillation is a known risk factor for stroke in CAD patients, but data on other CAD severities is limited.

Purpose of the Study:

  • To investigate the association between coronary atherosclerosis severity and stroke risk.
  • To determine if multi-vessel CAD increases stroke risk in symptomatic patients without atrial fibrillation or flutter.

Main Methods:

  • Prospective study of 1,183 symptomatic CAD patients without atrial fibrillation/flutter undergoing coronary angiography.
  • Follow-up for a mean of 6.7 years to record stroke events.
  • COX proportional hazard regression model used to analyze the association between CAD severity and stroke risk.

Main Results:

  • Fifty strokes occurred during the follow-up period.
  • Patients who experienced strokes had a higher prevalence of multi-vessel CAD (62% vs. 46%, p < 0.01).
  • Multi-vessel CAD was significantly associated with an increased stroke hazard ratio (HR) of 1.8 (CI 1.03-3.43).

Conclusions:

  • Symptomatic patients with multi-vessel coronary artery disease are at a significantly higher risk of stroke.
  • Coronary atherosclerosis severity, specifically multi-vessel disease, is an independent predictor of stroke in this population.
  • These findings highlight the importance of aggressive risk factor management in multi-vessel CAD patients to prevent stroke.

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