Li Ai-Hsien, Chu Yiu-Tong, Yang Lin-Hsue, Chen Kuo-Ching, Chu Shu-Hsun
Cardiovascular Center, Far Eastern Memorial Hospital, Banchao, Taipei, Taiwan.
Heart Vessels. 2007 Sep;22(5):297-302. doi: 10.1007/s00380-006-0971-8. Epub 2007 Sep 20.
Cerebral artery stenosis (CAS) has the same pathogenesis as coronary artery disease (CAD), but the coexistence of these two diseases has been rarely reported. To detect coexistent CAS in CAD patients, we conducted a study of simultaneous coronary and cerebral angiography. Of the 663 consecutive newly diagnosed CAD patients who had not yet been explored to have CAS, 80 were admitted to undergo angiography of bilateral carotid and vertebral system during the same procedure. We defined significant vascular stenosis, either located intracranially or extracranially, as the lesions of diameter stenosis more than 50%. Association between carotid or vertebral stenosis and their potential risk factors were also analyzed. Of our patients, 18 (22.5%) had significant extracranial vascular stenosis, 14 (17.5%) suffered from intracranial stenosis, and 20 (25%) had both. Only 28 patients (35%) had no significant intracranial or extracranial stenosis. None of the demographic parameters as hypertension or diabetes showed significant differences between the cerebral patent group and the CAS group, except for the number of coronary stenotic vessels (1.71 +/- 0.81 versus 2.69 +/- 0.64, P < 0.001). The number of coronary stenotic vessels is correlated well to the number of cerebral stenotic lesions (r = 0.562, P < 0.001). Besides, 8 of the cerebral stenotic patients and 2 of the cerebral patent patients had ischemic stroke previously. We conclude the CAS is coexistent in more than half of the CAD patients in this study. Our study also implies a proportional increase in the severity of CAS to CAD severity.
脑动脉狭窄(CAS)与冠状动脉疾病(CAD)具有相同的发病机制,但这两种疾病并存的情况鲜有报道。为了检测CAD患者中并存的CAS,我们进行了一项冠状动脉和脑血管同步造影的研究。在663例连续新诊断的尚未进行CAS检查的CAD患者中,80例患者在同一手术过程中接受了双侧颈动脉和椎骨系统的血管造影。我们将颅内或颅外直径狭窄超过50%的病变定义为显著血管狭窄。我们还分析了颈动脉或椎动脉狭窄与其潜在危险因素之间的关联。在我们的患者中,18例(22.5%)有显著的颅外血管狭窄,14例(17.5%)有颅内狭窄,20例(25%)两者都有。只有28例患者(35%)没有显著的颅内或颅外狭窄。除了冠状动脉狭窄血管数量外,高血压或糖尿病等人口统计学参数在脑动脉通畅组和CAS组之间没有显著差异(1.71±0.81对2.69±0.64,P<0.001)。冠状动脉狭窄血管数量与脑动脉狭窄病变数量密切相关(r = 0.562,P<0.001)。此外,8例脑动脉狭窄患者和2例脑动脉通畅患者既往有缺血性卒中病史。我们得出结论,在本研究中,超过一半的CAD患者并存CAS。我们的研究还表明,CAS的严重程度与CAD的严重程度成比例增加。