Prevalence of Intracranial Atherosclerosis among Patients with Coronary Artery Disease: A 1-Year Hospital-Based Study

Abstract

Background: There are limited data on the prevalence of intracranial atherosclerotic disease (ICAD) in patients with coronary artery disease (CAD) worldwide and especially among Egyptians. The purpose of the present study was to determine the prevalence and correlates of ICAD in patients with CAD. Methods: From January 1, 2012 to January 1, 2013, we recruited 118 consecutive patients who had ischemic heart disease. All patients were assessed for vascular risk factors and the existence of stroke or transient ischemic attack (TIA) and were evaluated by extracranial and transcranial color-coded sonography. All patients underwent coronary angiography. Clinical, echocardiographic and angiographic variables were tested by univariate and multivariate analysis. Results: Out of 118 consecutive patients with CAD, intracranial disease was detected in 14 patients (11.9%). Eight patients (6.8%) had stenosis >50%, while 6 patients (5.1%) had stenosis <50%. The univariate analysis showed that the strongest variables associated with ICAD were the presence of recent or old stroke or TIA, followed by moderate or severe extracranial stenosis, and multivessel or left main CAD. Conclusion: We observed low prevalence (6.8%) of high-grade ICAD among Egyptian patients with CAD. Multivessel or left main CAD and moderate-to-severe extracranial carotid stenosis were the strongest predictors for the existence of ICAD among CAD patients.

Coronary Heart Disease Concomitant with Atherosclerotic Cerebrovascular Disease

“…Meanwhile, the severity of CHD is positively correlated with the degree of carotid and intracranial artery stenosis [9]. Abd-Allah F et al [10] found that the prevalence of CHD concomitant with intracranial atherosclerosis was 11.9%. In addition, multivessel or the left main coronary artery stenosis and moderate-tosevere extracranial CAS were the strongest predictors for the existence of intracranial atherosclerosis among CHD patients.…”

“…Beyond that, as an independent risk factor, CHD increases the risk of a stroke three times, and is a significant contributor to death among ischemic cerebral stroke (ICS) patients [10]. Taking patients without CAD as the reference, the age-and sex-adjusted hazard ratio of cardiac and cerebrovascular events was 4.36 (95% CI, 1.35-14.12) for patients with asymptomatic CHD, and 6.86 (95% CI, 2.15-21.91) for patients with known CHD after the incidence of ICS [11], which suggests the risk of recurrent CVD events will be high in patients with cardio-cerebral vascular combined disease.…”

Koronarine Širdies Liga Sergančiųjų Smegenų Pokyčių Įvertinimas

“…Vienerių metų trukmės studijoje Kaire (Egiptas), tiriant egiptiečių populiaciją, tarp pacientų, sergančių KŠL, nustatytas IAS dažnis 11,9 proc. [16]. Taigi, galima teigti, jog intrakranijinių kraujagyslių pažeidimų vertinimas gali būti vienas iš KŠL sergančių ligonių prognozės kriterijų.…”