[Prevalence of asymptomatic atherothrombotic lesions and risk of vascular events in patients with a stroke].
OBJECTIVE
To estimate the prevalence of asymptomatic atherothrombotic lesions and the absolute risk of vascular events in patients with ischemic stroke.


METHODS
We conducted a systematic review of studies published between 1980 and 2004 which allowed calculating prevalence of asymptomatic lesions and absolute risks of vascular events in stroke patients. Studies included in the review of absolute risks had to include at least 100 patients followed for at least 1 year and with less than 5% of lost to follow-up.


RESULTS
Coronarography was used in only one study which does not provide any precise estimation of the prevalence of asymptomatic coronary lesions. Depending on the population and the method used for the diagnosis of coronary disease, the prevalence of asymptomatic coronary artery disease ranged from 25 through 60%. Very few studies have been devoted to the prevalence of abdominal aortic disease in stroke patients. The prevalence of abdominal aortic aneurysm has been estimated to 1% and that of peripheral arterial disease to 10%. Thirty-six cohorts were identified. The absolute risk of myocardial infarction was about 2%/year and that of vascular death 2%/year.


CONCLUSIONS
Stroke patients carry a high risk of coronary and vascular events. Additional studies are required to better identify patients with a high prevalence of asymptomatic atherosclerotic lesions and with a high risk of vascular events.
Touzé
E
E
Service de Neurologie, Hôpital Sainte-Anne, Paris. e.touze@ch-sainte-anne.fr
Varenne
O
O
Priollet
P
P
Alpérovitch
A
A
Mas
J L
JL
D050197:Atherosclerosis / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology; D006801:Humans; D015995:Prevalence; D020521:Stroke / Q000503:physiopathology*