Assessment of stroke and concomitant cerebrovascular disease with heart disease requires invasive treatment: analysis of 249 consecutive patients with heart disease.
OBJECTIVE
The aim of this study was to analyze the relationships of cerebrovascular disease (CVD), heart problems, and stroke in patients who required an invasive cardiac procedure.


METHODS
We enrolled 249 consecutive patients who required to or underwent invasive cardiac treatment and divided into a non-CVD group (n = 116) and a CVD group (n = 133). The latter group was divided into a coronary artery disease (CAD) group (n = 118) and a non-CAD group such as cardiac structural lesions (n = 15).


RESULTS
No significant relationship with significant cerebrovascular stenosis was observed in either the CADs or non-CADs. The incidence of past stroke was significantly higher in the CVD group than that in the non-CVD group (12.8 vs. 3.4%; p = 0.017). Previous stroke event had increased odds of having significant cerebrovascular stenosis (odds ratio, 3.919, p = 0.006). In patients with both cardiac disease and the CVD, perioperative stroke was only one case (0.9%). The main source of stroke was cardiogenic in the immediate results and cerebrovascular lesions in the delayed results (1-12 months).


CONCLUSIONS
The risk of perioperative stroke was very low in combined cardiac disease and the CVD. However, for preventing ischemic stroke due to the predetected cerebrovascular lesions, precautionary efforts could be needed for patients undergoing an invasive cardiac procedure, and concomitant cerebrovascular lesions should be considered as main source of delayed ischemic stroke.
Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Myeong Jin
MJ
Kim
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea.
Hyun
H
Song
Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea.
Se-Yang
SY
Oh
Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea.
Jai Ho
JH
Choi
Department of Radiology, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea.
Bum-Soo
BS
Kim
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea.
Joonkyu
J
Kang
Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea.
Yong Sam
YS
Shin
D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D016896:Treatment Outcome