Distribution of risk factors in relation to the presence of cerebral angiographic lesions in TIA and minor stroke patients

Abstract

In a series of patients with TIA or minor stroke we have investigated the possibility of a different distribution of risk factors according to the presence or absence of angiographic lesions of the cerebral arterial circulation. The differences observed, though not statistically significant, argue for a more severe and widespread atherosclerotic process in patients with positive angiography. A significant proportion of these patients present associated insufficiency of the coronary circulation, demonstrated indirectly by exercise testing. The exercise test presents a positive predictive power of 41% for cerebral angiographic lesions.

Ischemic cardiopathy and other heart disorders: Differences in risk of cerebrovascular disease and in its association with carotid obstruction

“…So it is often difficult to decide with certainty whether the carotid or cardiac lesion is responsible for a cerebrovascular disease (CVD). Vice versa, it has been found that in patients with TIAs an ischemic heart disease and not a stroke was the major cause of death [2,11,13], that the presence of angiographic lesions in patients with TIAs or minor strokes is more often associated with ischemie heart diseases, though not statistically significantly [1], and that the lesions correlated with an increase of cardiac ischemias in patients with TIAs --observed either by angiography [7] or by cervicad Doppler [4] --were ulcerated lesions and obstructions of more than 50% of the lumen. Vice versa, it has been found that in patients with TIAs an ischemic heart disease and not a stroke was the major cause of death [2,11,13], that the presence of angiographic lesions in patients with TIAs or minor strokes is more often associated with ischemie heart diseases, though not statistically significantly [1], and that the lesions correlated with an increase of cardiac ischemias in patients with TIAs --observed either by angiography [7] or by cervicad Doppler [4] --were ulcerated lesions and obstructions of more than 50% of the lumen.…”