ARYA Atherosclerosis Journal

The Incidence of Cardiovascular Events in Small Versus Large Ischemic Stroke; A Three-Year Cohort Study

Document Type : Original Article

Authors

Marzieh Tajmirriahi 1
Mohammad Saadatnia 2
Hassan Shemirani 3
Masoumeh Sadeghi 4
Alireza Chamasemani 4
Ali Safaei 5

1 Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

5 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute; Isfahan University of Medical Sciences; Isfahan; Iran

https://doi.org/10.48305/arya.2023.26660.2820
Abstract
INTRODUCTION: Cerebral ischemia and coronary artery disease (CAD), the major leading causes of mortality and morbidity worldwide, are pathophysiologically interrelated. Cerebral ischemic events are categorized as large or small vessels disease. The current study compares the factors related to CAD events incidence following ischemic large versus small disease CVA.
METHOD: The current cohort study was conducted on 225 patients with ischemic stroke in two groups of large (n=75) and small (n=150) vessel disease during 2018-19. The patients’ demographic, medical, and clinical characteristics were recruited. They were followed for three years regarding the incidence of CAD events, including ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina (UA), and sudden cardiac death (SCD). Data about the coronary angiography, computed tomography angiography (CTA), Single Photon Emission Computed Tomography (SPECT), and the therapeutic approach were gathered.
RESULTS: There were insignificant differences between the patients with small versus large vessels CVA in terms of ACS incidence (P-value=0.105), type of the events (P-value=0.836), angiographic (P-value=0.671), SPECT (P-value=0.99) and CTA findings (P-value>0.99) and approached CAD (P-value=0.728). Cox regression assessments revealed an increased risk of CAD events due to large versus small vessels disease after adjustments for hypertension, diabetes mellitus, dyslipidemia, re-stroke, and the previous history of IHD (HR=2.005, 95%CI: 1.093-2.988, P-value=0.021).
CONCLUSION: According to the findings of this study, large-vessel involvement in an ischemic stroke was associated with more than a two-fold increase in the three-year probability of ischemic heart disease incidencet.
 

Keywords

Coronary artery disease
Cardiovascular disease
Ischemic stroke
Cohort studies
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ARYA Atherosclerosis Journal
Volume 19, Issue 5
September and October 2023
Pages 35-42

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