Coronary Artery Disease and Risk of Major Vascular Events After Cerebral Infarction

被引:56
作者
Amarenco, Pierre [1 ,2 ,3 ,4 ]
Lavallee, Philippa C. [1 ,2 ,3 ,4 ]
Labreuche, Julien [1 ,3 ,4 ]
Ducrocq, Gregory [1 ,6 ]
Juliard, Jean-Michel [1 ,6 ]
Feldman, Laurent [1 ,2 ,6 ]
Cabrejo, Lucie [1 ,3 ,4 ]
Meseguer, Elena [1 ,3 ,4 ]
Guidoux, Celine [1 ,3 ,4 ]
Adrai, Valerie [3 ,4 ]
Ratani, Samina [3 ,4 ]
Kusmierek, Jerome [3 ,4 ]
Lapergue, Bertrand [1 ,3 ,4 ]
Klein, Isabelle F. [1 ,5 ]
Gongora-Rivera, Fernando [3 ,4 ]
Jaramillo, Arturo [3 ,4 ]
Abboud, Halim [3 ,4 ]
Olivot, Jean-Marc [3 ,4 ]
Mazighi, Mikael [1 ,2 ,3 ,4 ]
Touboul, Pierre-Jean [1 ,2 ,3 ,4 ]
Steg, Philippe Gabriel [1 ,2 ,6 ]
机构
[1] INSERM, U 698, Paris, France
[2] Univ Paris Diderot, Paris, France
[3] Hop Bichat Claude Bernard, AP HP, Dept Neurol, F-75877 Paris, France
[4] Hop Bichat Claude Bernard, AP HP, Stroke Ctr, F-75877 Paris, France
[5] Hop Bichat Claude Bernard, AP HP, Dept Radiol, Neuroradiol Unit, F-75877 Paris, France
[6] Hop Bichat Claude Bernard, AP HP, Dept Cardiol, F-75877 Paris, France
关键词
atherosclerosis; cerebral infarction; infarction; TRANSIENT ISCHEMIC ATTACK; HEALTH-CARE PROFESSIONALS; LONG-TERM SURVIVAL; MYOCARDIAL-INFARCTION; 1ST-EVER STROKE; PREVENTION; PREVALENCE; GUIDELINES; STATEMENT; COUNCIL;
D O I
10.1161/STROKEAHA.111.000142
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-The impact of asymptomatic coronary artery disease on the risk of major vascular events in patients with cerebral infarction is unknown. Methods-Four hundred five patients with acute cerebral infarction underwent carotid, femoral artery, thoracic, and abdominal aorta ultrasound examination. Of 342 patients with no known coronary heart disease, 315 underwent coronary angiography. We evaluated the 2-year risk of major vascular events (myocardial infarction, resuscitation after cardiac arrest, hospitalization for unstable angina or heart failure, stroke, or major peripheral arterial disease events) in patients with known coronary heart disease (n=63), and in the no known coronary heart disease group (n=315) as a function of coronary angiographic status (n=315). Results-At 2 years, the estimated risk of major vascular events was 11.0% (95% confidence interval, 8.2-14.7). According to baseline coronary angiography, estimated risk was 3.4% in patients with no coronary artery disease (n=120), 8.0% with asymptomatic coronary artery stenosis <50% (n=113), 16.2% with asymptomatic coronary artery stenosis >= 50% (n=81), and 24.1% with known coronary heart disease (P<0.0001). Using no coronary artery disease as the reference, the age- and sex-adjusted hazard ratio (95% confidence interval) of vascular events was 2.10 (0.63-6.96) for asymptomatic coronary stenosis <50%, 4.36 (1.35-14.12) for asymptomatic coronary stenosis >= 50%, and 6.86 (2.15-21.31) for known coronary artery disease. Conclusions-In patients with nonfatal cerebral infarction, presence and extent of asymptomatic stenoses on coronary angiography are strong predictors of major vascular events within 2 years.
引用
收藏
页码:1505 / +
页数:16
相关论文
共 17 条
[1]   Coronary risk evaluation in patients with transient ischemic attack and ischemic stroke - A scientific statement for healthcare professionals from the stroke council and the council on clinical cardiology of the American Heart Association/American Stroke Association [J].
Adams, RJ ;
Chimowitz, MI ;
Alpert, JS ;
Awad, IA ;
Cerqueria, MD ;
Fayad, P ;
Taubert, KA .
CIRCULATION, 2003, 108 (10) :1278-1290
[2]   Prevalence of Coronary Atherosclerosis in Patients With Cerebral Infarction [J].
Amarenco, Pierre ;
Lavallee, Philippa C. ;
Labreuche, Julien ;
Ducrocq, Gregory ;
Juliard, Jean-Michel ;
Feldman, Laurent ;
Cabrejo, Lucie ;
Meseguer, Elena ;
Guidoux, Celine ;
Adrai, Valerie ;
Ratani, Samina ;
Kusmierek, Jerome ;
Lapergue, Bertrand ;
Klein, Isabelle F. ;
Gongora-Rivera, Fernando ;
Jaramillo, Arturo ;
Mazighi, Mikael ;
Touboul, Pierre-Jean ;
Steg, Philippe Gabriel .
STROKE, 2011, 42 (01) :22-29
[3]   Coronary Heart Disease Risk in Patients With Stroke or Transient Ischemic Attack and No Known Coronary Heart Disease Findings From the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Trial [J].
Amarenco, Pierre ;
Goldstein, Larry B. ;
Sillesen, Henrik ;
Benavente, Oscar ;
Zweifler, Richard M. ;
Callahan, Alfred, III ;
Hennerici, Michael G. ;
Zivin, Justin A. ;
Welch, K. Michael A. .
STROKE, 2010, 41 (03) :426-430
[4]  
Amarenco P, 2006, NEW ENGL J MED, V355, P549
[5]   2007 focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction - A report of the American college of cardiology/American heart association task force on practice guidelines [J].
Antman, Elliott M. ;
Hand, Mary ;
Armstrong, Paul W. ;
Bates, Eric R. ;
Green, Lee A. ;
Halasyamani, Lakshmi K. ;
Hochman, Judith S. ;
Krumholz, Harlan M. ;
Lamas, Gervasio A. ;
Mullany, Charles J. ;
Pearle, David L. ;
Sloan, Michael A. ;
Smith, Sidney C., Jr. .
CIRCULATION, 2008, 117 (02) :296-329
[6]   Optimal medical therapy with or without PCI for stable coronary disease [J].
Boden, William E. ;
O'Rourke, Robert A. ;
Teo, Koon K. ;
Hartigan, Pamela M. ;
Maron, David J. ;
Kostuk, William J. ;
Knudtson, Merril ;
Dada, Marcin ;
Casperson, Paul ;
Harris, Crystal L. ;
Chaitman, Bernard R. ;
Shaw, Leslee ;
Gosselin, Gilbert ;
Nawaz, Shah ;
Title, Lawrence M. ;
Gau, Gerald ;
Blaustein, Alvin S. ;
Booth, David C. ;
Bates, Eric R. ;
Spertus, John A. ;
Berman, Daniel S. ;
Mancini, G. B. John ;
Weintraub, William S. ;
Boden, W. ;
O'Rourke, R. ;
Teo, K. ;
Hartigan, P. ;
Weintraub, W. ;
Maron, D. ;
Mancini, J. ;
Weintraub, W. ;
Boden, W. ;
O'Rourke, R. ;
Teo, K. ;
Hartigan, P. ;
Knudtson, M. ;
Maron, D. ;
Bates, E. ;
Blaustein, A. ;
Booth, D. ;
Carere, R. ;
Ellis, S. ;
Gosselin, G. ;
Gau, G. ;
Jacobs, A. ;
King, S., III ;
Kostuk, W. ;
Harris, C. ;
Spertus, J. ;
Peduzzi, P. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (15) :1503-1516
[7]   Long-term survival and causes of death after stroke [J].
Bronnum-Hansen, H ;
Davidsen, M ;
Thorvaldsen, P .
STROKE, 2001, 32 (09) :2131-2136
[8]   Prevalence of Asymptomatic Coronary Artery Disease in Ischemic Stroke Patients The PRECORIS Study [J].
Calvet, David ;
Touze, Emmanuel ;
Varenne, Olivier ;
Sablayrolles, Jean-Louis ;
Weber, Simon ;
Mas, Jean-Louis .
CIRCULATION, 2010, 121 (14) :1623-1629
[9]   LONG-TERM SURVIVAL AFTER 1ST-EVER STROKE - THE OXFORDSHIRE COMMUNITY STROKE PROJECT [J].
DENNIS, MS ;
BURN, JPS ;
SANDERCOCK, PAG ;
BAMFORD, JM ;
WADE, DT ;
WARLOW, CP .
STROKE, 1993, 24 (06) :796-800
[10]   Recurrent stroke and cardiac risks after first ischemic stroke - The Northern Manhattan Study [J].
Dhamoon, MS ;
Sciacca, RR ;
Rundek, T ;
Sacco, RL ;
Elkind, MSV .
NEUROLOGY, 2006, 66 (05) :641-646