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


Journal Article

BACKGROUND: While patients with coronary artery disease (CAD) and cerebrovascular disease share similar risk factor profiles, data on whether IS can be considered a "CAD equivalent" are limited. We aimed to determine whether ischemic stroke is an independent predictor of CAD by using cardiac computed tomography angiography (CTA). METHODS: We analyzed the CTA in 392 patients with no history of CAD (24 patients with acute IS and 368 patients with acute chest pain). Extent of plaque burden was additionally dichotomized into 0-4 versus >4 segments. RESULTS: Patients with IS had a near 5-fold increase odds of having coronary artery plaque (odds ratio [OR] 4.9, P<0.01) as compared to those without IS. After adjustment for age, gender, and traditional cardiac risk factors, there remained a near 4-fold increase odds for coronary plaque (adjusted OR 3.7, P=0.04). When stratified by extent of plaque, patients with IS had over 18-fold increase odds of having >4 segments of plaque than 0-4 segments as compared to patients without stroke (OR 18.3, P<0.01), which remained significantly associated in adjusted analysis (adjusted OR 12.1, P<0.001). CONCLUSION: Acute IS is independently associated with higher risk and greater extent of CAD compared to patients with acute chest pain at low-to-intermediate risk for acute coronary syndrome.

Full Text

Duke Authors

Cited Authors

  • Jensen, JK; Medina, HM; Nørgaard, BL; Øvrehus, KA; Jensen, JM; Nielsen, LH; Maurovich-Horvat, P; Engel, L-C; Januzzi, JL; Hoffmann, U; Truong, QA

Published Date

  • October 18, 2012

Published In

Volume / Issue

  • 160 / 3

Start / End Page

  • 171 - 174

PubMed ID

  • 21543126

Pubmed Central ID

  • 21543126

Electronic International Standard Serial Number (EISSN)

  • 1874-1754

Digital Object Identifier (DOI)

  • 10.1016/j.ijcard.2011.04.006


  • eng

Conference Location

  • Netherlands