Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease.

Autor:	de Araújo ALV; Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil., Santos RD; Heart Institute (Instituto do Coração), University of São Paulo, Medical School Hospital, São Paulo, Brazil.; Hospital Israelita Albert Einstein, Academic Research Organization, São Paulo, Brazil., Bittencourt MS; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States., Dantas RN Jr; Heart Institute (Instituto do Coração), University of São Paulo, Medical School Hospital, São Paulo, Brazil.; Hospital Israelita Albert Einstein, Academic Research Organization, São Paulo, Brazil., Oshiro CA; Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil., Nomura CH; Heart Institute (Instituto do Coração), University of São Paulo, Medical School Hospital, São Paulo, Brazil.; Hospital Israelita Albert Einstein, Academic Research Organization, São Paulo, Brazil., Bor-Seng-Shu E; Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil., Oliveira ML; Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil., Leite CDC; Department of Radiology and Oncology, University of São Paulo, São Paulo, Brazil., Martin MDGM; Department of Radiology and Oncology, University of São Paulo, São Paulo, Brazil., Alves MM; Neurology and Neurosurgery Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Silva GS; Neurology and Neurosurgery Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Silva VM; Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil., Conforto AB; Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2023 Apr 12; Vol. 14, pp. 1082275. Date of Electronic Publication: 2023 Apr 12 (Print Publication: 2023).
DOI:	10.3389/fneur.2023.1082275
Abstrakt:	Background: The coronary calcium score (CAC) measured on chest computerized tomography is a risk marker of cardiac events and mortality. We compared CAC scores in two multiethnic groups without symptomatic coronary artery disease: subjects in the chronic phase after stroke or transient ischemic attack and at least one symptomatic stenosis ≥50% in the carotid or vertebrobasilar territories (Group athero ) and a control group (Group control ). Methods: In this cross-sectional study, Group athero included two subgroups: Group ExtraorIntra , with stenoses in either cervical or intracranial arteries, and Group Extra&Intra , with stenoses in at least one cervical and one intracranial artery. Group control had no history of prior stroke/transient ischemic attacks and no stenoses ≥50% in cervical or intracranial arteries. Age and sex were comparable in all groups. Frequencies of CAC ≥100 and CAC > 0 were compared between Group athero and Group control , as well as between Group ExtraorIntr , Group Extra&Intra , and Group control , with bivariate logistic regressions. Multivariate analyses were also performed. Results: A total of 120 patients were included: 80 in Group athero and 40 in Group control. CAC >0 was significantly more frequent in Group athero (85%) than Group control (OR, 4.19; 1.74-10.07; p = 0.001). Rates of CAC ≥100 were not significantly different between Group athero and Group control but were significantly greater in Group Extra&Intra ( n = 13) when compared to Group control (OR 4.67; 1.21-18.04; p = 0.025). In multivariate-adjusted analyses, "Group athero " and "Group Extra&Intra " were significantly associated with CAC. Conclusion: The frequency of coronary calcification was higher in subjects with stroke caused by large-artery atherosclerosis than in controls. Competing Interests: RS has received honoraria related to consulting, research and or speaker activities from: Amgen, Aché, Astra Zeneca, Esperion, Kowa, Merck, Novo-Nordisk, PTC, Pfizer, and Sanofi/Regeneron. MB has received speaker fees from GE healthcare. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 de Araújo, Santos, Bittencourt, Dantas, Oshiro, Nomura, Bor-Seng-Shu, Oliveira, Leite, Martin, Alves, Silva, Silva and Conforto.)
Databáze:	MEDLINE
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