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Poor long-term outcomes in stroke patients with asymptomatic coronary artery disease in heart CT

Title
Poor long-term outcomes in stroke patients with asymptomatic coronary artery disease in heart CT
Authors
Yoo J.Song D.Baek J.-H.Kim K.Kim J.Song T.-J.Lee H.S.Choi D.Kim Y.D.Nam H.S.Heo J.H.
Ewha Authors
송태진
SCOPUS Author ID
송태진scopus
Issue Date
2017
Journal Title
Atherosclerosis
ISSN
0021-9150JCR Link
Citation
vol. 265, pp. 7 - 13
Keywords
Coronary artery diseaseIschemic strokeMajor adverse cardiac eventMortalityMultidetector computerized tomography
Publisher
Elsevier Ireland Ltd
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background and aims Although stroke patients have a high risk of ischemic heart disease, little information is available on the risk of coronary events in stroke patients with asymptomatic coronary artery disease (CAD). We investigated the long-term vascular outcomes in stroke patients with asymptomatic CAD diagnosed with multi-detector coronary computed tomography (MDCT). Methods This study was a retrospective analysis using a prospective cohort of ischemic stroke patients. We included consecutive stroke patients without history or symptoms of CAD who underwent MDCT. We investigated the long-term risk of major adverse cardiovascular events (MACE: cardiovascular mortality, ischemic stroke, myocardial infarction, unstable angina, and urgent coronary revascularization) and composite of MACE/all-cause mortality/elective coronary revascularization. We further investigated the value of MDCT for MACE prediction. Results Among the 1893 included patients, 1349 (71.3%) patients had some degree of CAD and 654 patients (34.5%) had significant (≥50%) CAD. At follow-up (median, 4.4 years), MACE occurred in 230 patients (12.2%). Event rates of MACE increased with the increasing extent of CAD. After adjustment for age, sex, and risk factors, the hazard ratios for MACE in mild CAD, 1-VD, 2-VD, and 3-VD or left main coronary disease were 1.28 (95% confidence interval [CI]: 0.88–1.87), 1.39 (95% CI: 0.90–2.16), 2.22 (95% CI: 1.39–3.55), and 2.91 (95% CI: 1.82–4.65), respectively (no CAD as a reference). Diagnosis of asymptomatic CAD significantly improved the prediction of MACE. Conclusions Asymptomatic CAD detected on MDCT was associated with increased risks of vascular events or deaths in acute stroke patients. © 2017 Elsevier B.V.
DOI
10.1016/j.atherosclerosis.2017.07.029
Appears in Collections:
의과대학 > 의학과 > Journal papers
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