Prevalence of subclinical coronary artery disease in ischemic stroke patients.
BACKGROUND
Recently, ischemic stroke has emerged as a new coronary artery disease (CAD) risk equivalent. Our purpose is to study the prevalence of CAD in ischemic stroke patients compared with that in non-stroke patients.


METHODS AND RESULTS
We measured coronary calcium score (CCS) in 151 ischemic stroke patients without known CAD (stroke group) and compared it with 151 age- and sex-matched non-stroke patients (control group). CCS was significantly higher in the stroke group than in the control group (stroke group, median: 64, interquartile range: 3-382 vs. control group, median: 3, interquartile range: 0-65, p<0.0001). High-risk CAD, defined as a CCS≥400, was detected in 24.5% of the stroke group compared with 9.3% of the control group (p<0.0001). Agreement between the Framingham risk score and CCS was found in only 62 patients (41.1%). In a multiple logistic regression analysis, age [hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.03-1.14], diabetes (HR 2.97, 95%CI 1.52-5.78), stroke (HR 3.85, 95%CI 1.89-7.81), and male sex (HR 4.41, 95%CI 1.82-0.75) were significantly associated with high-risk CAD (p<0.001).


CONCLUSIONS
Our results show that the prevalence of subclinical CAD in ischemic stroke patients was high, and that a quarter of them had high-risk CAD. Age, diabetes, stroke, and male sex were independent predictors of high-risk CAD.
['Iwasaki|Kohichiro|K|', 'Haraoka|Kayo|K|', 'Hamaguchi|Toshikazu|T|', 'Imamura|Takaki|T|', 'Kawada|Sanami|S|', 'Ohno|Manabu|M|', 'Kashihara|Kenichi|K|']
D000367:Age Factors D000368:Aged D002118:Calcium D003324:Coronary Artery Disease D003331:Coronary Vessels D048909:Diabetes Complications D005260:Female D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D015995:Prevalence D012307:Risk Factors D012737:Sex Factors D020521:Stroke D061205:Vascular Calcification
Coronary artery disease Ischemic stroke Coronary calcium score Cardiac computed tomography