Risk of a coronary event in patients after ischemic stroke or transient ischemic attack
Ivan Poledník1, Jakub Sulzenko1, Petr Widimsky1
1Department of Cardiology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady; Prague-Czech Republic.
Insights
Coronary artery disease (CAD) is common in stroke survivors, with many unaware of their condition. Early detection and treatment of silent CAD can significantly improve outcomes for these high-risk patients.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Vascular Disease
Background:
- Coronary artery disease (CAD) and stroke are leading global causes of death, imposing significant health and economic burdens.
- Ischemic stroke and transient ischemic attack (TIA) survivors exhibit a higher prevalence of coronary atherosclerosis.
- These patients face an elevated risk of myocardial infarction and non-stroke vascular death.
Purpose of the Study:
- To investigate the prevalence of coronary atherosclerosis in ischemic stroke survivors and TIA patients.
- To assess the cardiovascular risk in this patient population.
- To determine the impact of detecting and treating silent CAD.
Main Methods:
- A literature search was conducted on PubMed.
- Studies focused on coronary atherosclerosis in ischemic stroke survivors and TIA patients were reviewed.
- Cardiovascular risk assessment in these patients was analyzed.
Main Results:
- Coronary plaques were found in 48%-70% of stroke survivors without a prior CAD diagnosis.
- Significant stenosis (≥1 coronary artery) was identified in 31% of these patients.
- CAD is a primary contributor to morbidity and mortality in stroke survivors.
Conclusions:
- Coronary artery disease is highly prevalent in ischemic stroke and TIA survivors, often asymptomatic.
- Screening for and managing silent CAD in these individuals is crucial.
- Intervention may improve long-term prognosis and survival rates.
Abstract:
Coronary artery disease (CAD) together with stroke are the leading causes of death worldwide, and together, they pre-sent a health and economic burden. Ischemic stroke survivors and patients who suffered transient ischemic attack (TIA) have a higher prevalence of coronary atherosclerosis, and they have a relatively high risk of myocardial infarcti-on and nonstroke vascular death. Pubmed was searched for studies focused on investigating coronary atherosclerosis in ischemic stroke survivors or patients who suffered TIA and their cardiovascular risk assessment. There were corona-ry plaques in 48%-70% of stroke survivors without a known history of CAD, and significant stenosis of at least one coronary artery can be found in 31% of these patients. CAD is a major cause of morbidity and mortality in stroke survivors. Detection and treatment of silent CAD may improve the long-term outcome and survival of these patients.
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