title: Prevalence of symptomatic and asymptomatic coronary artery disease in patients with stroke.
abstract: Background. Studies have shown that myocardial infarction is a leading cause of death in patients recovering from stroke or transient ischaemic attacks. We aimed to study the prevalence of symptomatic and asymptomatic coronary artery disease (CAD) in patients with stroke. Methods. Eighty-six patients with stroke were evaluated for risk factors and presence of CAD. Patients without a previous diagnosis of CAD underwent stress-rest gated technetium-99m (Tc99m) tetrofosmin myocardial perfusion SPECT (MPS) scan to estimate the presence or absence of a reversible perfusion deficit. Results. Thirty-three patients (clinically asymptomatic for CAD) did not consent for the MPS scan. Among the remaining 53 patients, 13 patients had been previously diagnosed to have CAD, 8 patients were suspected to have underlying CAD and 32 patients were asymptomatic. Among the patients with suspected CAD, 2 had abnormal MPS scans and one had triple-vessel disease on coronary angiography. Of the asymptomatic patients, 6 had CAD. The overall proportion of CAD among patients with stroke was 41.5% (22/53) and that of asymptomatic CAD 18.8% (6/32). Conclusion. A considerable number of patients with stroke may have associated CAD. An optimal management strategy in stroke patients who have silent CAD may improve clinical outcomes.
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Neurology.
authors.forename: Kapil
authors.initials: K
authors.lastname: Aggarwal
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Neurology.
authors.forename: Rohit
authors.initials: R
authors.lastname: Bhatia
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Cardiology.
authors.forename: Gautam
authors.initials: G
authors.lastname: Sharma
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Nuclear Medicine.
authors.forename: Chetan
authors.initials: C
authors.lastname: Patel
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Neurology.
authors.forename: M V
authors.initials: MV
authors.lastname: Padma
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Neurology.
authors.forename: Kameshwar
authors.initials: K
authors.lastname: Prasad
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Neurology.
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India - Department of Neurology.
authors.forename: Mamta Bhushan
authors.initials: MB
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D055424:Cardiac-Gated Imaging Techniques; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011877:Radionuclide Imaging; D012307:Risk Factors; D020521:Stroke / Q000150:complications*