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Predictors of Concomitant Coronary Artery Disease and Major Cardiovascular Events in Patients with Acute Ischemic
Cigdem Ileri1, Beste Ozben1, Zekeriya Dogan1
1Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey.
Insights
Acute ischemic stroke patients with higher cardiovascular risk scores, troponin I levels, and carotid plaques are more likely to have concomitant coronary artery disease (CAD). Further investigation for CAD is recommended in these high-risk stroke patients.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Coronary artery disease (CAD) and ischemic stroke share common risk factors.
- Understanding the interplay between these conditions is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of concurrent CAD in patients presenting with acute ischemic stroke.
- To identify predictors of concomitant CAD in this patient population.
Main Methods:
- A cohort of 105 acute ischemic stroke patients underwent cardiovascular risk assessment.
- Coronary angiography was used to diagnose significant coronary artery stenosis (≥50%).
- Predictive values of Framingham Heart Study Risk Score, Troponin I, and carotid artery intima-media thickness were analyzed.
Main Results:
- Twenty-seven percent of ischemic stroke patients had documented concomitant CAD.
- Higher cardiovascular risk scores, elevated troponin I levels, and prevalent carotid plaques were associated with CAD.
- Specific cut-off values were identified for predicting CAD: Framingham score (≥22%), Troponin I (≥0.05 ng/mL), and carotid intima-media thickness (≥0.80 mm).
Conclusions:
- Stroke patients with elevated Framingham Heart Study Risk Score, troponin I, and carotid plaques warrant further investigation for underlying CAD.
- Early detection of CAD in stroke patients can guide preventative strategies.
Background:
Coronary artery disease (CAD) and ischemic stroke share the same risk factors.
Objective:
The aim of the study was to explore the prevalence and predictors of concomitant CAD in acute ischemic stroke patients.
Methods:
One hundred and five patients (64.3 ± 15.0 years, 61 male) presenting with acute ischemic stroke documented by neuroimaging were consecutively included. All patients were carefully evaluated to determine their cardiovascular disease risk scores. The patients who had been previously shown to have ≥50% stenosis in at least one of the major coronary arteries by coronary angiography were grouped as CAD patients.
Results:
Of the 105 stroke patients, 27 patients had documented concomitant CAD. The stroke patients with CAD had higher cardiovascular risk scores and troponin I levels and carotid plaques were more prevalent. ROC analysis determined cut-off values as ≥22% for Framingham Heart Study Risk Score, ≥0.05 ng/mL for Troponin I, and ≥0.80 mm for carotid artery intima-media thickness to predict concomitant CAD. During 6 months of follow-up, among the 78 stroke patients without documented CAD, 16 patients had experienced major cardiovascular events including myocardial infarction, recurrent stroke, or cardiovascular death. These patients had higher Framingham Heart Study Risk Score and high-sensitive C reactive protein levels.
Conclusion:
Our study suggests stroke patients with higher Framingham Heart Study Risk Score and troponin I levels and carotid plaques be further investigated for the presence of concomitant CAD.
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