Rokey R, Rolak L A, Harati Y, Kutka N, Verani M S
Ann Neurol. 1984 Jul;16(1):50-3. doi: 10.1002/ana.410160110.
Coronary artery disease is the cause of death in most patients who have transient ischemic attacks or stroke. Evaluation for this condition is not routinely performed in such patients, and no prospective studies have been reported. We prospectively examined 50 consecutive patients with transient ischemic attacks or mild stroke to determine the prevalence and importance of coronary artery disease. All patients were examined by a cardiologist and underwent both exercise thallium-201 scintigraphy and exercise radionuclide ventriculography. Sixteen patients were suspected to have coronary artery disease on the basis of clinical evaluation. In 15 of these the was confirmed by the nuclear scans. The remaining 34 patients had no clinical evidence of heart disease, yet 14 had abnormal cardiac scans. Twenty of 22 patients with abnormal scans who underwent cardiac catheterization had significant coronary artery disease or a cardiomyopathy. The discovery of heart disease altered clinical management in 13 patients. Overall, 29 of 50 patients had significant coronary artery disease, compared with a 7% prevalence of the condition in other patients of similar age at the same institution.
冠状动脉疾病是大多数短暂性脑缺血发作或中风患者的死因。对此类患者通常不进行该疾病的评估，且尚无前瞻性研究报告。我们前瞻性地检查了50例连续的短暂性脑缺血发作或轻度中风患者，以确定冠状动脉疾病的患病率及重要性。所有患者均由心脏病专家进行检查，并接受了运动铊-201心肌显像和运动放射性核素心室造影。16例患者基于临床评估怀疑患有冠状动脉疾病。其中15例经核扫描得到证实。其余34例患者无心脏病临床证据，但14例心脏扫描异常。22例扫描异常且接受心脏导管检查的患者中，20例患有严重冠状动脉疾病或心肌病。心脏病的发现改变了13例患者的临床治疗方案。总体而言，50例患者中有29例患有严重冠状动脉疾病，而同一机构中年龄相仿的其他患者该疾病患病率为7%。
