Prevalence of subclinical coronary artery disease in ischemic stroke patients

Abstract

BackgroundRecently, 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 resultsWe 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). ConclusionsOur 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.