Journal Article

DZNE-2022-00241

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Coronary angiography in acute ischemic stroke patients: frequency and determinants of pathological findings in a multicenter cohort study.

Litmeier, S. (First author)DZNE* ; Meinel, T. R. ; von Rennenberg, R.DZNE* ; Kniepert, J. U. ; Audebert, H. J. ; Endres, M.DZNE* ; Jung, S. ; Scheitz, J. F.Extern* ; Nolte, C.Extern*

2022
Springer Berlin

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Please use a persistent id in citations: doi:10.1007/s00415-022-11001-5

Abstract: Myocardial injury as indicated by cardiac troponin elevation is associated with poor prognosis in acute stroke patients. Coronary angiography (CAG) is the diagnostic gold-standard to rule-out underlying obstructive coronary artery disease (CAD) in these patients. However, weighing risks and benefits of coronary angiography (CAG) against each other is particularly challenging, because stroke patients undergoing CAG may have a higher risk for secondary intracranial bleeding. Current guidelines remain vague. Thus, the aim of this study was to analyze frequency of pathological findings of CAG and associated clinical factors.We analyzed indications and frequency of CAG performed in acute ischemic stroke patients in clinical routine in two European tertiary care hospitals from 2011 to 2018. All data were obtained retrospectively. Multiple logistic regression analyses were performed to identify variables associated with absence of obstructive coronary artery disease defined as presence of at least one coronary vessel stenosis ≥ 50%.A total of 139 AIS patients underwent CAG. Frequent indications for CAG were suspected acute coronary syndrome (N = 114) or scheduled cardiac surgery (N = 25). Acute coronary stenting was applied in 51/139 patients. Among patients with suspected acute coronary syndrome, no obstructive CAD was found in 27/114 patients. Absence of obstructive CAD was associated with insular cortex lesions, no clinical symptoms for ACS, less than three cardiovascular risk factors, younger age and normal wall motion.Several variables suggest absence of CAD in AIS patients and may help in clinical decision making in stroke patients with myocardial injury.

Keyword(s): Acute Coronary Syndrome: complications (MeSH) ; Acute Coronary Syndrome: diagnosis (MeSH) ; Coronary Angiography (MeSH) ; Coronary Artery Disease: complications (MeSH) ; Coronary Artery Disease: diagnosis (MeSH) ; Humans (MeSH) ; Ischemic Stroke (MeSH) ; Retrospective Studies (MeSH) ; Risk Factors (MeSH) ; Stroke: complications (MeSH) ; Stroke: diagnostic imaging (MeSH) ; Stroke: epidemiology (MeSH) ; Acute ischemic stroke ; Heart and brain axis ; Myocardial injury ; Stroke-heart-syndrome

Note: ISSN 1432-1459 not unique: **2 hits**.(CC BY)

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Contributing Institute(s):

1. Coordinator of Clinical Research (AG Endres)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2022

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Database coverage:
; ; ; BIOSIS Previews ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; Ebsco Academic Search ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Web of Science Core Collection

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