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Predictive utility of stress tests in the detection of asymptomatic coronary artery disease in atherosclerotic stroke patients.

dc.rights.licenseopenen_US
dc.contributor.authorLIEGEY, Jean-Sébastien
dc.contributor.authorFAWAZ, Sami
dc.contributor.authorDUCOS, Claire
dc.contributor.authorPUCHEU, Yann
dc.contributor.authorBOULESTREAU, Romain
dc.contributor.authorSIBON, Igor
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorCOUFFINHAL, Thierry
dc.date.accessioned2023-10-09T14:09:57Z
dc.date.available2023-10-09T14:09:57Z
dc.date.issued2023-09-01
dc.identifier.issn1532-8511en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/184363
dc.description.abstractEnWhether and how atherosclerotic ischemic stroke patients should be investigated for asymptomatic coronary artery disease (CAD) is controversial. Our aim was to carry out a prospective observational study to determine the frequency and predictors of functionally significant coronary stenosis in these patients as well as the predictors of major adverse cardiovascular events (MACE) during post-stroke follow-up. From January 2014 to June 2018, patients with atherosclerotic ischemic stroke were referred from the stroke unit to our cardiovascular department 3+/- 1 months after the acute event where they benefited from evaluation of cardiovascular risk factors, vascular and myocardial disease. Main outcome was defined as the prevalence of myocardial ischemia defined by perfusion stress echography 3 months after stroke. Secondary outcome (MACE) was defined as the incidence of stroke, transient ischemic attack (TIA), acute coronary syndrome, cardiovascular (CV) death or coronary or peripheral revascularization during a 3 year follow-up. Three hundred and twenty five patients (92% of strokes and 8% TIA) were included and median follow-up was 1075 days. At 3 months post-stroke, myocardial ischemia was found in 17 patients (5.2%). During the 3 year follow-up, 11 MACE occurred (3.4%, all in the non-ischemic group) of which 6 were recurrent strokes. In multivariate analysis, myocardial ischemia was significantly associated with the number of atheromatous vascular beds (OR 4.3; 95% CI, 1.7 to 10.6) and ECG signs of necrosis (OR 6.5; 95% CI, 1.9 to 21.9). MACE were also associated with ECG signs of necrosis (OR 3.5; 95% CI, 1.3 to 9.1), and unrelated to myocardial ischemia. Myocardial ischemia and CV events were infrequent and both strongly associated with ECG signs of necrosis, suggesting a low yield of stress tests and the potential for a more straightforward algorithm in the choice of patients eligible to coronary angiogram or other coronary imaging in post-stroke setting.
dc.language.isoENen_US
dc.subjectArticle clinique
dc.subject.enHumans
dc.subject.enCoronary Artery Disease
dc.subject.enIschemic Attack
dc.subject.enTransient
dc.subject.enExercise Test
dc.subject.enRisk Factors
dc.subject.enStroke
dc.subject.enAtherosclerosis
dc.subject.enMyocardial Ischemia
dc.subject.enIschemic Stroke
dc.subject.enNecrosis
dc.subject.enPrognosis
dc.title.enPredictive utility of stress tests in the detection of asymptomatic coronary artery disease in atherosclerotic stroke patients.
dc.title.alternativeJ Stroke Cerebrovasc Disen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2023.107290en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
dc.identifier.pubmed37567133en_US
bordeaux.journalJournal of Stroke and Cerebrovascular Diseasesen_US
bordeaux.page107290en_US
bordeaux.volume32en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires (BMC) - UMR 1034en_US
bordeaux.issue9en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcepubmed
hal.identifierhal-04233653
hal.version1
hal.date.transferred2023-10-09T14:09:59Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
workflow.import.sourcepubmed
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal%20of%20Stroke%20and%20Cerebrovascular%20Diseases&rft.date=2023-09-01&rft.volume=32&rft.issue=9&rft.spage=107290&rft.epage=107290&rft.eissn=1532-8511&rft.issn=1532-8511&rft.au=LIEGEY,%20Jean-S%C3%A9bastien&FAWAZ,%20Sami&DUCOS,%20Claire&PUCHEU,%20Yann&BOULESTREAU,%20Romain&rft.genre=article


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