Introduction: Cerebral ischemia and coronary artery disease (CAD), the major leading cause of mortality and morbidity worldwide, are pathophysiologically interrelated. The 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.
Methods: 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 was insignificant differences between the patients with small versus large vessels CVA in term 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 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 two folds increase in three years probability of ischemic heart disease incidence.