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Heart artery blockages appear to raise stroke risk

Friday March 1, 2013
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Blockages in heart arteries could raise the risk of having a stroke, even among those considered low-risk, according to a study.

"This study demonstrates that stroke risk is tightly aligned with coronary atherosclerosis, showing the closely related nature of cardiovascular and cerebrovascular disease," Dirm M. Hermann, MD, the study’s lead investigator and professor of vascular neurology and dementia at University Hospital Essen in Germany, said in a news release.

"This raises the need for intensified interdisciplinary efforts for providing adequate disease prevention and management strategies."

In the study, researchers used non-invasive electron beam-computed tomography to determine how much plaque had built up in the coronary arteries of 4,180 patients who had no previous strokes or myocardial infarction. The patients, men and women ages 45 to 75, were followed for about eight years, during which 92 strokes occurred.

The blockages, caused by coronary artery calcification, were significantly higher in those who had a stroke than those who did not. Those who had CAC levels of more than 400 Hounsfield units (HU), a density measurement, were three times more likely to have a stroke than those with CAC levels below 399 HU.

CAC measurements were more potent in predicting stroke in patients younger than 65 and those at low risk for cardiovascular disease, the researchers said. CAC levels were an accurate predictor of stroke in men and women regardless of whether patients suffered from atrial fibrillation.

"Not only atrial fibrillation but also CAC has to be taken into account as a marker of risk for stroke events," Hermann said.

Study patients who suffered a stroke had a median age of about 65, had a higher body mass index and were more likely to have hypertension, diabetes and high cholesterol levels. Although the study was conducted in Germany, Hermann said the findings among the middle-aged participants likely can be extrapolated to Americans in the same age group.

The study appeared Feb. 28 on the website of Stroke, a journal of the American Heart Association. A PDF of the study is available at http://stroke.ahajournals.org/content/early/2013/02/28/STROKEAHA.111.678078.abstract.


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