The onset of ischemic stroke in the coronary heart disease patients

Cho, Jeong Hoon; Choi, Il Saing; Lee, Byung In; Chung, Nam Sik

Abstract

BACKGROUND: Coronary heart disease (CAD) has been known to be a risk factor of ischemic stoke. But, in our country, there has been no systematized study about the incidence of ischemic stroke (IS) after CAD, influencing factors and interval to ischemic stroke . So there is a possibility of different result from previous studies in other countries.
METHODS
In this study, we analyzed the stroke influencing factors, interval and stroke type of 2192 CAD patients composed of myocardial infarction (MI) (554 patients) and angina pectoris (1638 patients) who admitted Yonsei university Severance hospital since 1992 Jan. to 1994 Dec. through 3 year follow up.
RESULTS
After 3 year follow up of 2192 CAD patients, total 40 cases of ischemic stroke (including transient ischemic attack) developed. Among total CAD patients, influencing factors of IS were atrial fibrillation (p<0.001) and ejection fraction lower than 55 % (p=0.034). Especially atrial fibrillation was the most powerful influencing factor (odds ratio=7.8201, 95 % confidence interval=2.9281-20.8854). IS occurrence was most frequent up to 1 year after diagnosis of CAD(60 % of IS cases), especially highest frequency was demonstrated up to 1 month (50 % of the IS cases within 1 year). This pattern was same to all CAD types. There were not any differences of incidence and interval to IS between acute MI and angina pectoris patients. In MI (554 patients) patients 2.5 % (14 cases) incidence of IS was demonstrated for 3 years and influencing factors of IS occurrence were age (p=0.044) and atrial fibrillation (p=0.004). The outstanding treatment of minimizing IS occurrence was not demonstrated. In angina pectoris (1638 patients) patients, 1.6 % (26 cases) incidence of IS was demonstrated for 3 years and influencing factors of IS occurrence were 1) atrial fibrillation (p=0.0031), 2) Diabetes mellitus (p=0.0058) 3) left ventricular hypertrophy (p=0.0057) 4) hypertension (p=0.0228). There was not an outstanding treatment which let IS occurrence minimalized in sta.