Silent brain infarctions in patients with coronary heart diseases. A Spanish population survey.
Coronary artery disease is a recognized risk factor for symptomatic ischaemic stroke but the influence on asymptomatic stroke has not been clearly determined.
The purpose of this work was to determine the relationship between coronary heart disease and silent brain infarcts and the influence of vascular risk factors and carotid atherosclerosis in a representative sample of Spanish patients with symptomatic coronary artery disease.
A consecutive sample of 100 subjects with myocardial infarction, angina or both were included in the survey.
Patients with a potential source of emboli from the heart were excluded.
As main baseline variables, we considered vascular risk factors ; complete cardiological study, including coronary angiography ; brain computed tomography (CT) to detect infarcts ; echo-Doppler of supra-aortic vessels to detect stenosis ; and carotid angiography, when appropriate.
As the outcome variable, we observed the incidence of symptomatic stroke after an 18 month mean follow-up.
We found silent brain infarction in 30 patients (93% were of lacunar type).
None of the vascular risk factors was related to brain infarcts either in univariate or multivariate analysis.
Carotid atherosclerosis was the only significant predictor in a model of logistic regression (P<0.0005), although the lesions were bilateral in the majority of cases.
We observed a very low incidence of symptomatic stroke after a mean follow-up of 18 months. (...)
Mots-clés Pascal : Ramollissement cérébral, Asymptomatique, Cardiopathie coronaire, Athérosclérose, Carotide, Espagne, Europe, Tomodensitométrie, Facteur risque, Fréquence, Epidémiologie, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Artère pathologie, Radiodiagnostic, Imagerie médicale
Mots-clés Pascal anglais : Cerebral infarction, Asymptomatic, Coronary heart disease, Atherosclerosis, Carotid, Spain, Europe, Computerized axial tomography, Risk factor, Frequency, Epidemiology, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Cerebrovascular disease, Cardiovascular disease, Vascular disease, Arterial disease, Radiodiagnosis, Medical imagery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0103297
Code Inist : 002B17C. Création : 22/06/1998.