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de Araújo ALV, Santos RD, Bittencourt MS, Dantas RN, Oshiro CA, Nomura CH, Bor-Seng-Shu E, Oliveira MDL, Leite CDC, Martin MDGM, Alves MM, Silva GS, Silva VM, Conforto AB. Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease. Front Neurol 2023; 14:1082275. [PMID: 37122290 PMCID: PMC10130387 DOI: 10.3389/fneur.2023.1082275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/24/2023] [Indexed: 05/02/2023] Open
Abstract
Background The coronary calcium score (CAC) measured on chest computerized tomography is a risk marker of cardiac events and mortality. We compared CAC scores in two multiethnic groups without symptomatic coronary artery disease: subjects in the chronic phase after stroke or transient ischemic attack and at least one symptomatic stenosis ≥50% in the carotid or vertebrobasilar territories (Groupathero) and a control group (Groupcontrol). Methods In this cross-sectional study, Groupathero included two subgroups: GroupExtraorIntra, with stenoses in either cervical or intracranial arteries, and GroupExtra&Intra, with stenoses in at least one cervical and one intracranial artery. Groupcontrol had no history of prior stroke/transient ischemic attacks and no stenoses ≥50% in cervical or intracranial arteries. Age and sex were comparable in all groups. Frequencies of CAC ≥100 and CAC > 0 were compared between Groupathero and Groupcontrol, as well as between GroupExtraorIntr, GroupExtra&Intra, and Groupcontrol, with bivariate logistic regressions. Multivariate analyses were also performed. Results A total of 120 patients were included: 80 in Groupathero and 40 in Groupcontrol. CAC >0 was significantly more frequent in Groupathero (85%) than Groupcontrol (OR, 4.19; 1.74-10.07; p = 0.001). Rates of CAC ≥100 were not significantly different between Groupathero and Groupcontrol but were significantly greater in GroupExtra&Intra (n = 13) when compared to Groupcontrol (OR 4.67; 1.21-18.04; p = 0.025). In multivariate-adjusted analyses, "Groupathero" and "GroupExtra&Intra" were significantly associated with CAC. Conclusion The frequency of coronary calcification was higher in subjects with stroke caused by large-artery atherosclerosis than in controls.
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Affiliation(s)
| | - Raul D. Santos
- Heart Institute (Instituto do Coração), University of São Paulo, Medical School Hospital, São Paulo, Brazil
- Hospital Israelita Albert Einstein, Academic Research Organization, São Paulo, Brazil
| | - Marcio Sommer Bittencourt
- Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Roberto Nery Dantas
- Heart Institute (Instituto do Coração), University of São Paulo, Medical School Hospital, São Paulo, Brazil
- Hospital Israelita Albert Einstein, Academic Research Organization, São Paulo, Brazil
| | - Carlos André Oshiro
- Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil
| | - Cesar Higa Nomura
- Heart Institute (Instituto do Coração), University of São Paulo, Medical School Hospital, São Paulo, Brazil
- Hospital Israelita Albert Einstein, Academic Research Organization, São Paulo, Brazil
| | - Edson Bor-Seng-Shu
- Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Maramelia Miranda Alves
- Neurology and Neurosurgery Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Gisele Sampaio Silva
- Neurology and Neurosurgery Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Victor Marinho Silva
- Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil
| | - Adriana Bastos Conforto
- Hospital das Clinicas, Neurology Clinical Division, University of São Paulo, São Paulo, Brazil
- *Correspondence: Adriana Bastos Conforto
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Araújo ALVD, Lucato LT, Tinone G, Leitão-Filho HAP, Yamamoto FI, Conforto AB. Carotid artery dissection plus subdural hematoma after a roller-coaster ride. Arq Neuro-Psiquiatr 2014; 72:976. [DOI: 10.1590/0004-282x20140169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 09/09/2014] [Indexed: 11/22/2022]
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