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Coronary heart disease

Asymptomatic Coronary Artery Disease Pervasive in Ischaemic Stroke Survivors

Strategic Insights

— 1 min read

Current study results on Heart Disorders and Diseases - Heart Disease have been published, revealing a high burden of asymptomatic coronary artery disease (CAD) in ischaemic stroke survivors. The research emphasizes the importance of routine coronary assessment in ischaemic stroke patients to prevent future major adverse cardiovascular events (MACE). Funders for this research include the National Health & Medical Research Council (NHMRC) of Australia and the National Heart Foundation of Australia.

Key Takeaways:

  • The pooled prevalence of any coronary atherosclerosis in ischaemic stroke survivors was 66.8% (95% CI 57.2%-75.1%), with substantial heterogeneity (I-2 = 95.2%).
  • The pooled prevalence of obstructive (50%) stenosis was 29.3% with substantial heterogeneity (I-2 = 91%).
  • High-risk coronary anatomy (triple vessel disease or left main stenosis) was found in 7.0% (95% CI 4%-12%) with high heterogeneity I-2 = 72%.
  • One study examined high-risk plaques and found a prevalence of 5.9%.
  • The presence of obstructive CAD confers a Hazard Ratio (HR) of 8.0 (95% CI 1.7-37.1, p = 0.007) for future MACE.
  • Asymptomatic CAD is common in ischaemic stroke survivors, with the presence and severity of asymptomatic CAD strongly associating with the risk of future MACE.
  • Additional research is warranted to evaluate the benefits of routine coronary assessment in ischaemic stroke patients.

Statistics:

  • 2983 studies were identified, of which 17 were included in the systematic review and meta-analysis.
  • A total of 6862 participants were included in the studies from 2008 to 2022.
  • The pooled prevalence of any coronary atherosclerosis was 66.8% (95% CI 57.2%-75.1%).
  • The pooled prevalence of obstructive (50%) stenosis was 29.3% with substantial heterogeneity (I-2 = 91%).

Sources:

  • Asymptomatic Coronary Artery Disease In Ischaemic Stroke Survivors: a Systematic Review and Meta-analysis. European Stroke Journal, 2024;9(3):540-554.
  • Rahul G. Muthalaly, Monash University, Victorian Heart Inst, Clayton, Vic, Australia. Contact: rahul.muthalaly@monash.edu.
  • Timothy B. Abrahams, Nitesh Nerlekar, Adam J. Nelson, Sean Tan, Jasmine Chan, Thanh Phan, Henry Ma and Stephen J. Nicholls.

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