Increased Risk of Cardiovascular Events in Stroke Patients Who had Not Undergone Evaluation for Coronary Artery Disease.
10.3349/ymj.2017.58.1.114
- Author:
Young Dae KIM
1
;
Dongbeom SONG
;
Hyo Suk NAM
;
Donghoon CHOI
;
Jung Sun KIM
;
Byeong Keuk KIM
;
Hyuk Jae CHANG
;
Hye Yeon CHOI
;
Kijeong LEE
;
Joonsang YOO
;
Hye Sun LEE
;
Chung Mo NAM
;
Ji Hoe HEO
Author Information
1. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. jhheo@yuhs.ac
- Publication Type:Comparative Study ; Original Article
- Keywords:
Stroke;
coronary disease;
outcome;
multi-detector coronary computed tomography
- MeSH:
Asymptomatic Diseases;
Coronary Artery Disease/*diagnostic imaging/mortality;
Female;
Follow-Up Studies;
Humans;
Male;
Multidetector Computed Tomography/*utilization;
Propensity Score;
Proportional Hazards Models;
Prospective Studies;
Recurrence;
Retrospective Studies;
Risk Assessment;
Risk Factors;
Stroke/*complications/mortality
- From:Yonsei Medical Journal
2017;58(1):114-122
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Although asymptomatic coronary artery occlusive disease is common in stroke patients, the long-term advantages of undergoing evaluation for coronary arterial disease using multi-detector coronary computed tomography (MDCT) have not been well established in stroke patients. We compared long-term cardio-cerebrovascular outcomes between patients who underwent MDCT and those who did not. MATERIALS AND METHODS: This was a retrospective study in a prospective cohort of consecutive ischemic stroke patients. Of the 3117 patients who were registered between July 2006 and December 2012, MDCT was performed in 1842 patients [MDCT (+) group] and not in 1275 patients [MDCT (−) group]. Occurrences of death, cardiovascular events, and recurrent stroke were compared between the groups using Cox proportional hazards models and propensity score analyses. RESULTS: During the mean follow-up of 38.0±24.8 months, 486 (15.6%) patients died, recurrent stroke occurred in 297 (9.5%), and cardiovascular events occurred in 60 patients (1.9%). Mean annual risks of death (9.34% vs. 2.47%), cardiovascular events (1.2% vs. 0.29%), and recurrent stroke (4.7% vs. 2.56%) were higher in the MDCT (−) group than in the MDCT (+) group. The Cox proportional hazards model and the five propensity score-adjusted models consistently demonstrated that the MDCT (−) group was at a high risk of cardiovascular events (hazard ratios 3.200, 95% confidence interval 1.172–8.735 in 1:1 propensity matching analysis) as well as death. The MDCT (−) group seemed to also have a higher risk of recurrent stroke. CONCLUSION: Acute stroke patients who underwent MDCT experienced fewer deaths, cardiovascular events, and recurrent strokes during follow-up.
