Abstract 17474: The Real World Prevalence of Cerebrovascular Disease Findings by Computed Tomography or Magnetic Resonance Imaging in Patients With Coronary Artery Disease
Background: Patients with coronary artery disease (CAD) are often complicated with cerebrovascular disease (CVD). Although there are many reports on the relation between stroke with symptomatic signs and CAD, there are few studies on CVD findings obtained from imaging examination irrespective of neurological signs. The aim was to examine the prevalence of CVD findings and clinical outcome in CAD patients.
Methods: In 1091 consecutive CAD patients (772 males, mean age 70.1±10.3) who required percutaneous coronary intervention (PCI), we examined the CVD findings by computed tomography (CT) or magnetic resonance imaging (MRI) of brain before PCI. Patients were classified into 4 CVD findings and non-CVD: 1) microbleeds (G1), 2) lacunar infarction (G2), 3) non-lacunar infarction more severe than lacunar infarction (G3), 4) old cerebral bleeding (G4), and 5) non-CVD findings (G0). Acute conditions of CVD were excluded. Clinical endpoints were cardiovascular death, myocardial infarction (MI), stroke, unstable angina (UA) and urgent revascularization.
Results: The number of CVD from cerebral imaging was 324 (29.7%) and there were 26 (2.4%), 125 (11.5%), 144 (13.2%), 29 (2.6%) and 767 (70.3%) in G1, G2, G3, G4 and G0, respectively. Patients with CVD findings had a high incidence of left main trunk or multi-vessels diseases, peripheral artery disease, chronic kidney disease and high age and high pulse wave velocity. Cardiovascular event rate was significantly higher in patients with CVD findings than in patients with non-CVD findings (9.6% vs. 4.7%, P=0.002). Details in clinical outcome were as follows: cardiovascular death (G1, G2, G3, G4, and G0; 0%, 0.8%, 2.8%, 3.4% and 0.9%, respectively), MI (0%, 0.8%, 0.7%, 3.4% and 0.5%), stroke (0%, 4.0%, 1.4%, 3.4%, and 0.7%), UA (3.8%, 4.0%, 4.2%, 6.9%, and 2.5%), revascularization (3.8%, 0.8%, 2.2%, 3.4% and 0.7%), respectively. Multiple regression analysis identified CVD findings as a predictor of clinical events (OR, 2.06; 95%CI, 1.18-3.60; P=0.001).
Conclusions: There was high incidence of MRI or CT findings of brain irrespective or with or without neurological signs in CAD patients. We should also pay attention to asymptomatic patients with microbleeds or lacunar infarction irrespective of overt previous stroke.
Author Disclosures: S. Hokimoto: None. N. Tabata: None. T. Akasaka: None. K. Sakamoto: None. E. Yamamoto: None. K. Tsujita: None. M. Yamamuro: None. K. Kaikita: None. S. Kojima: None. H. Ogawa: Other Research Support; Modest; Astellas Pharma Inc,. Other Research Support; Significant; Bayer. Honoraria; Modest; AstraZeneca K.K.. Honoraria; Significant; Takeda Pharmaceutical Co.,.
- © 2015 by American Heart Association, Inc.