Key result
Multi-vessel CAD is linked to ~80% higher stroke risk in patients without atrial fibrillation.
Why the study?
The association between the severity of coronary atherosclerosis and the risk of stroke in symptomatic CAD patients without atrial fibrillation or atrial flutter was unclear.
Does multi-vessel coronary artery disease increase the risk of stroke in symptomatic CAD patients without atrial fibrillation?
Cohort (n=1,183)
No
Does multi-vessel coronary artery disease increase the risk of stroke in symptomatic CAD patients without atrial fibrillation?
Hazard Ratio: 1.8 (95% CI 1.03–3.43)
Absolute Event Rate: 6% vs 2%
Symptomatic patients with multi-vessel coronary artery disease have a significantly higher risk of developing a stroke over a 7-year period, independent of atrial fibrillation.
Severity of coronary atherosclerosis may stratify stroke risk in non-AF CAD; hypothesis-generating and requires prospective validation before clinical use.
The purpose of this prospective study was to investigate the association between the severity of coronary atherosclerosis in angiography and the risk of stroke in symptomatic coronary artery disease (CAD) patients without atrial fibrillation or atrial flutter. Associations between stroke and coronary artery disease were examined in 1,183 subjects without a history of stroke and who were referred for diagnostic coronary angiography. Association between stoke and coronary artery disease was determined using the COX proportional hazard regression model. During the follow-up period (mean 6.7 years), 50 strokes occurred. In the group with strokes there was a higher prevalence of multi-vessel coronary artery disease (62 vs. 46 %, p < 0.01). In the COX proportional hazard regression model, multi-vessel CAD was significantly associated with the stroke hazard ratio (HR) of 1.8 (CI 1.03-3.43), determined from a 7-year period of observation. Symptomatic patients with multi-vessel CAD are thus at a high risk of stroke development.
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Sobiczewski et al. (2013) conducted a cohort in Symptomatic coronary artery disease (n=1,183). Multi-vessel coronary artery disease vs. No significant coronary artery stenosis was evaluated on Stroke incidence (HR 1.8, 95% CI 1.03-3.43). Multi-vessel coronary artery disease was significantly associated with an increased risk of stroke (HR 1.8) over a 7-year follow-up period in symptomatic patients without atrial fibrillation.
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