Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease

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de Araujo, Ana Luiza Vieira ; Santos, Raul D. ; Bittencourt, Marcio Sommer ; Dantas, Roberto Nery ; Oshiro, Carlos Andre ; Nomura, Cesar Higa ; Bor-Seng-Shu, Edson ; Oliveira, Marcelo de Lima ; Leite, Claudia da Costa ; Morais Martin, Maria da Graca ; Alves, Maramelia Miranda ; Silva, Gisele Sampaio ; Silva, Victor Marinho ; Conforto, Adriana Bastos

• Document type: Journal article
• Source: FRONTIERS IN NEUROLOGY; v. 14, p. 8-pg., 2023-04-12.

Abstract

BackgroundThe coronary calcium score (CAC) measured on chest computerized tomography is a risk marker of cardiac events and mortality. We compared CAC scores in two multiethnic groups without symptomatic coronary artery disease: subjects in the chronic phase after stroke or transient ischemic attack and at least one symptomatic stenosis >= 50% in the carotid or vertebrobasilar territories (Group(athero)) and a control group (Group(control)). MethodsIn this cross-sectional study, Group(athero) included two subgroups: Group(ExtraorIntra), with stenoses in either cervical or intracranial arteries, and Group(Extra&Intra), with stenoses in at least one cervical and one intracranial artery. Group(control) had no history of prior stroke/transient ischemic attacks and no stenoses >= 50% in cervical or intracranial arteries. Age and sex were comparable in all groups. Frequencies of CAC >= 100 and CAC > 0 were compared between Group(athero) and Group(control), as well as between Group(ExtraorIntr), Group(Extra&Intra), and Group(control), with bivariate logistic regressions. Multivariate analyses were also performed. ResultsA total of 120 patients were included: 80 in Group(athero) and 40 in Group(control.) CAC >0 was significantly more frequent in Group(athero) (85%) than Group(control) (OR, 4.19; 1.74-10.07; p = 0.001). Rates of CAC >= 100 were not significantly different between Group(athero) and Group(control) but were significantly greater in Group(Extra&Intra) (n = 13) when compared to Group(control) (OR 4.67; 1.21-18.04; p = 0.025). In multivariate-adjusted analyses, "Group(athero)" and "Group(Extra&Intra)" were significantly associated with CAC. ConclusionThe frequency of coronary calcification was higher in subjects with stroke caused by large-artery atherosclerosis than in controls. (AU)

• FAPESP's process: 14/03950-2 - Subclinical coronary atherosclerosis in patients with atherothrombotic ischemic stroke and in subjects without cerebrovascular disease
• Grantee: Adriana Bastos Conforto
• Support Opportunities: Regular Research Grants