Prognostic indicators for the onset of ischaemic versus haemorrhagic stroke in stable coronary artery disease
Journal
Medicine
Journal Volume
100
Journal Issue
48
Date Issued
2021-12-03
Author(s)
Wang, Wei-Ting
Wu, Tao-Cheng
Tseng, Wei-Kung
Lin, Tsung-Hsien
Yeh, Hung-I
Chang, Kuan-Cheng
Wang, Ji-Hung
Leu, Hsin-Bang
Yin, Wei-Hsian
Chen, Jaw-Wen
Abstract
The incidence of stroke may be increased in patients with coronary artery disease (CAD). We aimed to investigate the specific risk factors for the development of ischaemic and haemorrhagic stroke in stable CAD patients.Patients with stable CAD were prospectively enrolled for future cardiovascular events in Taiwan. All the patients had received coronary interventions and were stable for least 1 month before enrolment. The incidence of ischaemic stroke was identified and confirmed by telephone and hospital records. Baseline characteristics, including demographic data, lipid profiles, medications, and biomarkers for potential inflammatory and atherosclerosis, were analysed.In total, 1428 patients (age, 63.07 ± 11.4 years; 1207 males) were under standard medical treatment and regularly followed-up for at least 4 years. Multivariate logistic regression analysis showed that baseline serum myeloperoxidase (MPO) level (hazard ratio [HR]: 1.89, 95% CI: 1.16-3.10, P = .01) and statin use (HR: 0.37; 95% CI: 0.17-0.79, P = .01) were independently associated with the onset of ischaemic stroke. Age (HR: 1.07, 95% CI: 1.00-1.14, P = .04) and angiotensin receptor blocker (ARB) use (HR: 0.37, 95% CI: 0.17-0.79, P = .01) were independently associated with future onset of intracranial haemorrhage (ICH), implying the different mechanisms of ischaemic stroke and ICH.Age and ARB use were related to ICH onset. Baseline MPO level and statin use were independently associated with longer and shorter future ischaemic stroke onset in stable CAD patients, respectively. Further studies are indicated to confirm the potential mechanisms and advance individual risk stratification for the onset of different types of stroke in clinical CAD.
Subjects
coronary artery disease; haemorrhagic stroke; ischaemic stroke; low-density lipoprotein cholesterol; myeloperoxidase; statins; INTRACEREBRAL HEMORRHAGE; VASCULAR EVENTS; CASE-FATALITY; MORTALITY; RISK; POPULATION; ASSOCIATION; MECHANISMS; SEVERITY
SDGs
Other Subjects
1 alkyl 2 acetylglycerophosphocholine esterase; amino terminal pro brain natriuretic peptide; angiotensin receptor antagonist; creatinine; CXCL16 chemokine; dipeptidyl carboxypeptidase inhibitor; fatty acid binding protein 3; hemoglobin; high density lipoprotein cholesterol; myeloperoxidase; neutrophil gelatinase associated lipocalin; triacylglycerol; adult; Article; atherosclerosis; brain hemorrhage; controlled study; coronary artery disease; coronary risk; demography; electrocardiogram; female; follow up; heart infarction; human; incidence; ischemic stroke; laboratory test; major clinical study; male; medical record; middle aged; multicenter study; multivariate logistic regression analysis; observational study; percutaneous coronary intervention; prognosis; prospective study; Taiwan
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Type
journal article