Cardiovascular Disease in Male Patients with Carotid Transient Ischemic Attacks or Minor Strokes

Abstract

The authors tested the hypothesis that coronary heart disease and lower extremity atherosclerosis occur more frequently in patients with transient ische mic attacks (TIA) than in patients with minor stroke. Thirty-three consecutive male patients with TIA and 36 with minor stroke from the carotid artery terri tory were examined with ultrasonography of the cardiac, iliac, and femoral arteries; echocardiography (UCG); electrocardiogram (ECG); thallium scinti graphy (TS) of the myocardium; and assessment of the ankle/arm index (A/AI). TS showed myocardial infarctions to be more common among TIA patients than among minor stroke patients, 54% vs 19%, p=0.019. UCG showed the frequency of left ventricular and atrial dilatation to be higher in the TIA group than in the minor stroke group, 64% vs 27%, p=0.0084. Significant artery stenosis (≥ 50%) was not, however, more frequent in the TIA group than in the minor stroke group, nor was there any significant difference between the groups in A/AI. The frequency of TS-verified myocardial infarction (MI) was higher in the subgroup with ≥ 50% carotid artery stenosis than in that with < 50% stenosis, 61% vs 25%, p=0.022, and also higher in the pathological UCG subgroup than in the normal UCG subgroup, 50% vs 15%, p=0.025.

Thus, there was a greater incidence both of TS-verified MI and of UCG verified cardiac dilatation in the TIA group than in the minor stroke group but no difference between the groups in the degree of atherosclerosis either in the carotid or lower extremity regions. The findings constitute further support for a previous hypothesis of ours, that carotid TIA and minor stroke often differ in vascular pathophysiology.