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Journal of the Korean Neurological Association 1998;16(6): 761-768.
관 동맥 질환 환자에서 허혈성 뇌졸중의 발생
조정훈, 최일생, 이병인, 정남식*
연세대학교 의과대학 신경과학 교실, 심장내과학 교실*
The onset of ischemic stroke in the coronary heart disease patients
Jeong Hoon Cho, Il Saing Choi, Byung In Lee, Nam Sik Chung*
Department of Neurology, Cardiology*, College of Medicine, Yonsei University
Abstract
Background : Coronary heart disease (CAD) has been known to be a risk factor of ischemic stoke. But, in our country, there has been no systematized study about the incidence of ischemic stroke (IS) after CAD, influencing factors and interval to ischemic stroke . So there is a possibility of different result from previous studies in other countries. Methods : In this study, we analyzed the stroke influencing factors, interval and stroke type of 2192 CAD patients composed of myocardial infarction (MI) (554 patients) and angina pectoris (1638 patients) who admitted Yonsei university Severance hospital since 1992 Jan. to 1994 Dec. through 3 year follow up. Results : After 3 year follow up of 2192 CAD patients, total 40 cases of ischemic stroke (including transient ischemic attack) developed. Among total CAD patients, influencing factors of IS were atrial fibrillation (p<0.001) and ejection fraction lower than 55 % (p=0.034). Especially atrial fibrillation was the most powerful influencing factor (odds ratio=7.8201, 95 % confidence interval=2.9281-20.8854). IS occurrence was most frequent up to 1 year after diagnosis of CAD(60 % of IS cases), especially highest frequency was demonstrated up to 1 month (50 % of the IS cases within 1 year). This pattern was same to all CAD types. There were not any differences of incidence and interval to IS between acute MI and angina pectoris patients. In MI (554 patients) patients 2.5 % (14 cases) incidence of IS was demonstrated for 3 years and influencing factors of IS occurrence were age (p=0.044) and atrial fibrillation (p=0.004). The outstanding treatment of minimizing IS occurrence was not demonstrated. In angina pectoris (1638 patients) patients, 1.6 % (26 cases) incidence of IS was demonstrated for 3 years and influencing factors of IS occurrence were 1) atrial fibrillation (p=0.0031), 2) Diabetes mellitus (p=0.0058) 3) left ventricular hypertrophy (p=0.0057) 4) hypertension (p=0.0228). There was not an outstanding treatment which let IS occurrence minimalized in sta Key Words : coronary heart disease, myocardial infarction, angina pectoris, ischemic stroke