scholarly journals A History of Stroke/Transient Ischemic Attack Indicates High Risks of Cardiovascular Event and Hemorrhagic Stroke in Patients With Coronary Artery Disease

Circulation ◽  
2013 ◽  
Vol 127 (6) ◽  
pp. 730-738 ◽  
Author(s):  
Gregory Ducrocq ◽  
Pierre Amarenco ◽  
Julien Labreuche ◽  
Mark J. Alberts ◽  
Jean-Louis Mas ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Event ◽  
Transient Ischemic Attack ◽  
Hemorrhagic Stroke ◽  
History Of ◽  
Artery Disease ◽  
Ischemic Attack

Early Engagement in Exercise Improves Coronary Artery Disease Risk in Newly Diagnosed Transient Ischemic Attack Patients

2013 ◽  
Vol 8 (6) ◽  
pp. E29-E29 ◽  
Author(s):  
James Faulkner ◽  
Danielle Lambrick ◽  
Brandon Woolley ◽  
Lee Stoner ◽  
Laikin Wong ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Transient Ischemic Attack ◽  
Disease Risk ◽  
Coronary Artery Disease Risk ◽  
Newly Diagnosed ◽  
Artery Disease ◽  
Ischemic Attack

Abstract 101: Gender Has Differential Effects on Non-Hemorrhagic Stroke Outcomes

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Justin Pieper ◽  
Michael Ashamalla ◽  
Daniel Sedhom ◽  
Neil Yager ◽  
Ketan Ghate ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Renal Insufficiency ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Hemorrhagic Stroke ◽  
Peripheral Vascular ◽  
Stroke Outcomes ◽  
History Of ◽  
Artery Disease

Background: We sought to examine the relationship between gender, age, co-morbidities, and outcomes in patients with non-hemorrhagic stroke. Materials and methods: Retrospective chart review was performed on 517 consecutive non-hemorrhagic stroke patients (48% women, 20% with diabetes, 26.8% with CAD, 38% with dyslipidemia, 62.2% with HTN, 4.2% with peripheral vascular disease, 4.7% with renal insufficiency) treated at a single academic medical center. Results: Younger patients were more likely to be men (age<50 55%, 51-60 58.3%, 61-70 59.6%; p<0.05) while older patients were likely to be women (age 71-80 54.9%, >80 56.6; p<0.05). Accordingly, the subsequent analysis stratified the cohort into two groups, <70 and >70 years old. Regardless of age, men had a higher prevalence of CAD (age <70, 25.2% vs 18.8% in women, and age >70, 43.7% vs. 23.1% in women; p<0.05) and dyslipidemia (age <70, 43.4% vs 32.5% in women and age >70, 44.8% vs. 30.6% in women; p=.05). There were no significant gender based differences in BMI, prevalence of diabetes, hypertension, peripheral vascular disease, or chronic renal insufficiency. The mean follow up duration was 47.3+/-0.9 months. Gender did not affect mortality in patients younger than 70 years old (15.5% men vs. 15.6% women.) However in patients of age >70 mortality was significantly increased in men (50.5% in men vs. 41.7% in women; chi-squared p<0.001, log-rank p<0.0001, Figure). In logistic regression analysis, when compared to women younger than 70 years old, men of the same age had similar mortality (HR 1.0; 95%CI 0.5-1.9, p=0.980); while age greater than 70 conferred 4-5 fold increased risk of mortality (HR 3.9; 95%CI 2.1-7.0, p<0.0001 in women, and HR 5.5; 95%CI 3.0-10.3, p<0.0001 in men). When gender and age were accounted for, history of coronary artery disease and/or dyslipidemia did not affect the outcomes. Conclusion: Men with non-hemorrhagic stroke were more likely to have dyslipidemia and history of coronary artery disease. This, however, did not translate into increased mortality in younger men. Gender appears to have a differential effect on non-hemorrhagic stroke outcomes which warrants future investigation.

scholarly journals Essen Risk Score in Prediction of Myocardial Infarction After Transient Ischemic Attack or Ischemic Stroke Without Prior Coronary Artery Disease

Stroke ◽  
2019 ◽  
Vol 50 (12) ◽  
pp. 3393-3399 ◽  
Author(s):  
Marion Boulanger ◽  
Linxin Li ◽  
Shane Lyons ◽  
Nicola G. Lovett ◽  
Magdalena M. Kubiak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Risk Score ◽  
Transient Ischemic Attack ◽  
Artery Disease ◽  
Ischemic Attack

scholarly journals Coronary Artery Disease in Patients Presenting With Acute Ischemic Stroke or Transient Ischemic Attack and Elevated Troponin Levels

2022 ◽  
Vol 12 ◽  
Author(s):  
Mathieu Kruska ◽  
Anna Kolb ◽  
Christian Fastner ◽  
Iris Mildenberger ◽  
Svetlana Hetjens ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Transient Ischemic Attack ◽  
Large Artery ◽  
Elevated Troponin ◽  
Stroke Patients ◽  
Artery Disease ◽  
Ischemic Attack

Background: There is little information concerning the invasive coronary angiography (ICA) findings of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) with elevated troponin levels and suspected myocardial infarction (MI). This study analyzed patient characteristics associated with ICA outcomes.Methods: A total of 8,322 patients with AIS or TIA, treated between March 2010 and May 2020, were retrospectively screened for elevated serum troponin I at hospital admission. Patients in whom ICA was performed, due to suspected type 1 MI based on symptoms, echocardiography, and ECG, were categorized according to ICA results (non-obstructive coronary artery disease (CAD): ≥1 stenosis ≥50% but no stenosis ≥80%; obstructive CAD: any stenosis ≥80% or hemodynamically relevant stenosis assessed by FFR/iwFR).Results: Elevated troponin levels were detected in 2,205 (22.5%) patients, of whom 123 (5.6%) underwent ICA (mean age 71 ± 12 years; 67% male). CAD was present in 98 (80%) patients, of whom 51 (41%) were diagnosed with obstructive CAD. Thus, ICA findings of obstructive CAD accounted for 2.3% of patients with troponin elevation and 0.6% of all stroke patients. The clinical hallmarks of myocardial ischemia, including angina pectoris (31 vs. 15%, p &lt; 0.05) and regional wall motion abnormalities (49 vs. 32%, p = 0.07), and increased cardiovascular risk indicated obstructive CAD. While there was no association between lesion site or stroke severity and ICA findings, causal large-artery atherosclerosis was significantly more common in patients with obstructive coronary disease (p &lt; 0.05).Conclusion: The rate of obstructive CAD in patients with stroke or TIA and elevated troponin levels with suspected concomitant type I MI is low. The cumulation of several cardiovascular risk factors and clinical signs of MI were predictive. AIS patients with large-artery atherosclerosis and elevated troponin may represent an especially vulnerable subgroup of stroke patients with risk for obstructive CAD.

scholarly journals Optimizing Screening and Management of Asymptomatic Coronary Artery Disease in Patients With Stroke and Patients With Transient Ischemic Attack

Stroke ◽  
2009 ◽  
Vol 40 (10) ◽  
pp. 3407-3409 ◽  
Author(s):  
Bruce Ovbiagele ◽  
David S. Liebeskind ◽  
Doojin Kim ◽  
Latisha K. Ali ◽  
Sandra Pineda ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Transient Ischemic Attack ◽  
Artery Disease ◽  
Ischemic Attack ◽  
Asymptomatic Coronary Artery Disease

Abstract 717: An Association between Frontal Non-hemorrhagic Stroke and Atrial Fibrillation.

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Daniel Sedhom ◽  
Neil Yager ◽  
Michael Ashamalla ◽  
Ketan Ghate ◽  
Justin Pieper ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Logistic Regression ◽  
Coronary Artery ◽  
Hemorrhagic Stroke ◽  
Normal Sinus Rhythm ◽  
Multivariate Logistic Regression Analysis ◽  
Study Cohort ◽  
History Of ◽  
Artery Disease

Background: Atrial fibrillation is a known risk factor for thromboembolic events. We sought to investigate an association between arrhythmia and stroke location in patients with non-hemorrhagic stroke. Materials and methods: The study cohort included 514 consecutive patients with non-hemorrhagic stroke treated at a single academic center. Stroke location was classified as frontal, occipital, lacunar, brainstem, left or right temporal, left or right parietal, cerebellar and insular. ANOVA, chi-square and logistic regression analyses were used. The study was approved by the institutional IRB. Results: Frontal embolic stroke was noted more frequently in patients with atrial fibrillation (29% vs. 15% in normal sinus rhythm, NSR, p<0.0001). No other anatomic location of the stroke was associated with arrhythmia. Frontal strokes were more likely in patients with history of coronary artery disease (23% vs. 12%, p<0.005). However, there was no association between frontal stroke location and gender, age, history of hypertension, diabetes, dyslipidemia, peripheral vascular disease, or chronic renal insufficiency. In multivariate logistic regression analysis, atrial fibrillation (HR 2.3; 95% CI 1.2-4.5, p=0.018) and history of coronary artery disease (HR 2; 95%CI 1.2-3.4, p=0.012) remained important predictors of frontal strokes. Discussion: Non-hemorrhagic strokes are common in patients with atrial fibrillation. We found increased prevalence of frontal embolic strokes in atrial fibrillation, possible due to the dual blood supply the frontal cerebrum from both the middle and anterior cerebral arteries. This association is intriguing and requires further studies.

scholarly journals Serum Proprotein Convertase Subtilisin/ Kexin Type 9 Levels are Increased in Patients with Transient Ischemic Attack

2020 ◽  
pp. 5-11
Author(s):  
Thomas Tzimas ◽  
Eleni Pappa ◽  
Sebastien Filippas-Ntekouan ◽  
Maria Georgoula ◽  
Angelos Liontos ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Transient Ischemic Attack ◽  
Stable Coronary Artery Disease ◽  
Symptom Duration ◽  
Proprotein Convertase ◽  
Mean Values ◽  
Coronary Syndromes ◽  
Artery Disease ◽  
Ischemic Attack

Background: Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) is associated with hypercholesterolemia and atherosclerotic disease while its inhibition reduces cardiovascular risk. There is some evidence that serum PCSK9 concentrations are higher in patients with acute coronary syndromes compared with those with stable coronary artery disease, which has been attributed to a proatherogenic and prothrombotic state. Objective: This case-control pilot study investigated potential associations of PCSK9 in patients with transient ischemic attack (TIA). Methods: A total of 20 patients with a first-ever atherosclerotic non-cardioembolic TIA and 20 controls of similar age and sex were enrolled. Clinical characteristics, metabolic parameters, including serum PCSK9 within 24 hours from the onset of TIA symptoms were recorded. Results: The serum PCSK9 concentration was higher in TIA patients vs. controls (mean values, 248 ng/mL vs. 196 ng/mL, p = 0.02). In patients with TIA, serum PCSK9 correlated with age (r=0.603, p=0.03), history of coronary artery disease (r=0.515, p=0.020) and ABCD2 score (Age, Blood pressure, Clinical features, symptom Duration, Diabetes – a future stroke prediction tool) (r=0.512, p=0.021). In multivariate analysis, serum PCSK9 was independently associated with higher odds of TIA (1.16 per 10 ng/mL increase, 95% CI 1.01-1.34, p=0.035). Conclusions: Our findings indicate that serum PCSK9 levels are independently associated with atherosclerotic TIA and the risk of future stroke. Further investigation is needed to confirm these findings or to assess the use of PCSK9 as a target for early treatment as well as for secondary stroke prevention.

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