Cervical and Intracranial Atherosclerosis and Silent Brain Infarction in Japanese Patients with Coronary Artery Disease

Uekita, Kazumi; Hasebe, Naoyuki; Funayama, Naoki; Aoyama, Hidefumi; Kuroda, Kenji; Aizawa, Hitoshi; Kataoka, Ryo; Kikuchi, Kenjiro

doi:10.1159/000070117

Cited by 35 publications

(44 citation statements)

References 17 publications

(26 reference statements)

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“…Previous studies 10,11 reported high complication rates between carotid artery stenosis and severe CAD in patients undergoing coronary bypass surgery. Our study, including less severe CAD as well as severe CAD, supported these previous studies.…”

Section: Discussionmentioning

confidence: 92%

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Prevalence of Carotid Artery Stenosis in Patients With Coronary Artery Disease in Japanese Population

Tanimoto

Ikari

Tanabe

et al. 2005

Stroke

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Background and Purpose-Prevalence of carotid artery stenosis in patients with coronary artery disease (CAD) is unknown in Japanese population. Methods-The study populations consisted of 632 consecutive patients who underwent coronary angiography because of suspicion of CAD. All patients underwent carotid ultrasonography to screen carotid artery stenosis before coronary angiography. We defined echographic carotid stenosis as area stenosis of Ͼ50% or peak systolic velocity of Ͼ200 cm/s.

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Section: Discussionmentioning

confidence: 92%

“…It has been reported that Japanese patients who underwent coronary artery bypass grafting (CABG) because of severe CAD had a high incidence of carotid stenosis. 10,11 But there are few reports about the complication rate of carotid artery disease in Japanese patients with CAD other than the candidates for bypass surgery.…”

mentioning

confidence: 99%

Prevalence of Carotid Artery Stenosis in Patients With Coronary Artery Disease in Japanese Population

Tanimoto

Ikari

Tanabe

et al. 2005

Stroke

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“…23 Intracranial large artery atherosclerosis, 24 IMT of the common carotid artery, [25][26][27] ABI, 13,[27][28][29][30] and baPWV 13,31,32 have all been reported to be associated with CAD. In the present study, only intracranial large artery atherosclerosis was an independent predictor of asymptomatic CAD in patients with cerebral infarction.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Coronary Artery Disease in Japanese Patients With Cerebral Infarction Impact of Metabolic Syndrome and Intracranial Large Artery Atherosclerosis

Hoshino

Nakamura

Enomoto

et al. 2008

Circ J

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Background Patients with cerebral infarction have a high prevalence of asymptomatic coronary artery disease (CAD) and other vascular diseases, but there is a lack of such data for Japanese patients, so the present study investigated the prevalence of cardiovascular disease (CVD) in Japanese patients and determined the predictors of CAD. Methods and ResultsThe study group comprised 104 patients with cerebral infarction who had no history of CVD. All patients underwent coronary computed tomographic angiography, and systematic evaluation was done on the basis of the presence of other vascular diseases, CVD risk markers, and the degree of atherosclerosis. Of the total, 39 patients (37.5%) had CAD, 9 (8.7%) had carotid artery stenosis, 9 (8.7%) had peripheral artery disease of the lower limbs, and 3 (2.9%) had atherosclerotic renal artery stenosis. Multiple regression analysis showed that the presence of CAD was independently associated with metabolic syndrome (odds ratio (OR) 5.008, 95% confidence interval (CI) 1.538-16.309; p<0.01) and intracranial large artery atherosclerosis (OR 4.979, p<0.01). Conclusion Japanese patients with cerebral infarction have a high prevalence of CVD, especially asymptomatic CAD. Both metabolic syndrome and intracranial large artery atherosclerosis may be potential predictors for identifying patients with cerebral infarction who are at the highest risk of asymptomatic CAD. (Circ J 2008; 72: 404 -408)

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“…However, these tests have limitations for reflecting the degree of coronary artery atherosclerosis and the data on the safety of stress tests of CAD patients after ischemic stroke are limited [1]. A few authors have studied the relationship between CAD and ischemic stroke by directly measuring the degree of atherosclerosis [8,9,10,11]. Despite differences in the coronary and carotid systems in terms of disease manifestation and pathophysiology [12], most studies that directly measured atherosclerosis were performed on CAD patients [8,9,10,11] because of the technical and ethical problems of performing conventional coronary angiography in ischemic stroke patients.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Coronary Artery Atherosclerosis with Atherosclerosis of the Intracranial Cerebral Artery and the Extracranial Carotid Artery

et al. 2008

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Background: Investigating atherosclerosis of the coronary artery in ischemic stroke patients is clinically important because comorbidity is relatively common in such patients. We studied the relationship of atherosclerosis of the coronary artery to atherosclerosis of the intracranial cerebral artery and extracranial carotid artery. Further investigation was performed for determining the factors independently associated with coronary artery atherosclerosis in ischemic stroke patients. Methods: We consecutively recruited ischemic stroke patients who had no history of coronary artery disease, and they underwent vascular examination. Patient-based vascular assessment was performed with magnetic resonance angiography of the cerebral arteries and computed tomography coronary angiography. The factors independently associated with coronary artery stenosis (≧50%) were obtained from the conventional vascular risk factors and cerebral arterial stenosis using the logistic regression model. Results: Coronary artery stenosis was observed in 25.4% of the patients and this was associated with age (OR: 1.16, 95% CI: 1.03–1.30) and the presence of stenosis of the extracranial carotid artery (OR: 11.37, 95% CI: 1.88–68.75) after logistic regression analysis. Intracranial arterial stenosis was not independently related to coronary stenosis. Conclusion: Careful concern about coronary artery disease is needed when treating ischemic stroke patients who have atherosclerosis of the extracranial carotid artery.

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Cervical and Intracranial Atherosclerosis and Silent Brain Infarction in Japanese Patients with Coronary Artery Disease

Cited by 35 publications

References 17 publications

Prevalence of Carotid Artery Stenosis in Patients With Coronary Artery Disease in Japanese Population

Prevalence of Carotid Artery Stenosis in Patients With Coronary Artery Disease in Japanese Population

Prevalence of Coronary Artery Disease in Japanese Patients With Cerebral Infarction Impact of Metabolic Syndrome and Intracranial Large Artery Atherosclerosis

Correlation of Coronary Artery Atherosclerosis with Atherosclerosis of the Intracranial Cerebral Artery and the Extracranial Carotid Artery

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