title: Association of ischemic stroke to coronary artery disease using computed tomography coronary angiography.
abstract: BACKGROUND
  While patients with coronary artery disease (CAD) and cerebrovascular disease share similar risk factor profiles, data on whether IS can be considered a "CAD equivalent" are limited. We aimed to determine whether ischemic stroke is an independent predictor of CAD by using cardiac computed tomography angiography (CTA).
  
  
  METHODS
  We analyzed the CTA in 392 patients with no history of CAD (24 patients with acute IS and 368 patients with acute chest pain). Extent of plaque burden was additionally dichotomized into 0-4 versus >4 segments.
  
  
  RESULTS
  Patients with IS had a near 5-fold increase odds of having coronary artery plaque (odds ratio [OR] 4.9, P<0.01) as compared to those without IS. After adjustment for age, gender, and traditional cardiac risk factors, there remained a near 4-fold increase odds for coronary plaque (adjusted OR 3.7, P=0.04). When stratified by extent of plaque, patients with IS had over 18-fold increase odds of having >4 segments of plaque than 0-4 segments as compared to patients without stroke (OR 18.3, P<0.01), which remained significantly associated in adjusted analysis (adjusted OR 12.1, P<0.001).
  
  
  CONCLUSIONS
  Acute IS is independently associated with higher risk and greater extent of CAD compared to patients with acute chest pain at low-to-intermediate risk for acute coronary syndrome.
authors.affiliation: Department of Cardiology, Vejle Hospital, Denmark. jesperkjensen@dadlnet.dk
authors.forename: Jesper K
authors.initials: JK
authors.lastname: Jensen
authors.forename: Hector M
authors.initials: HM
authors.lastname: Medina
authors.forename: Bjarne L
authors.initials: BL
authors.lastname: Nørgaard
authors.forename: Kristian A
authors.initials: KA
authors.lastname: Øvrehus
authors.forename: Jesper M
authors.initials: JM
authors.lastname: Jensen
authors.forename: Lene H
authors.initials: LH
authors.lastname: Nielsen
authors.forename: Pal
authors.initials: P
authors.lastname: Maurovich-Horvat
authors.forename: Leif-Christopher
authors.initials: LC
authors.lastname: Engel
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Quynh A
authors.initials: QA
authors.lastname: Truong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015331:Cohort Studies; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*