Background: Coronary artery disease (CAD) and ischemic stroke are frequent coexistent conditions that share same risk factors. Guidelines recommend all ischemic stroke patients be assessed for cardiovascular risk to identify those at greater likelihood of morbidity and mortality from asymptomatic CAD. The aim of the study was to explore the predictors of CAD in ischemic stroke patients.
Methods: 105 patients (64.3 ± 15.0 years, 61 male) presenting with acute ischemic stroke documented by neuroimaging were consecutively included in the study. All patients were evaluated to determine their Framingham Heart Study Risk Score (FRS), SCORE index. Endothelial function and carotid artery intima-media thickness (CIMT) were assessed by brachial artery flow mediated dilatation (FMD) and carotid artery ultrasonography, respectively.
Results: Of the 105 patients; 27 patients had known CAD documented by coronary angiography. The characteristics and clinical findings of patients according to the presence of known CAD are listed in Table 1.The sensitivity and the specificity of parameters in predicting CAD in stroke patients are listed in Table 2. During a six month of follow-up, among the 78 stroke patients without CAD, 16 patients had experienced major cardiovascular event including myocardial infarction, stroke or cardiovascular death. These patients had higher FRS (23.8 ± 11.2% vs 16.6 ± 10.3% p=0.017) and hs-CRP level (49.5 ± 52.0mg/L vs 12.9 ± 16mg/L, p=0.018) compared to the non-CAD stroke patients without any cardiovascular event.
Conclusion: Our study suggests stroke patients with higher FRS and troponin I levels and carotid artery plaques be further investigated for the presence of concomitant CAD.