PMID- 11779917
OWN - NLM
STAT- MEDLINE
DCOM- 20020201
LR  - 20190727
IS  - 1524-4628 (Electronic)
IS  - 0039-2499 (Linking)
VI  - 33
IP  - 1
DP  - 2002 Jan
TI  - Severity of angina pectoris and risk of ischemic stroke.
PG  - 245-50
AB  - BACKGROUND AND PURPOSE: Ischemic stroke and coronary heart disease (CHD) share 
      risk factors and pathogenic process, ie, atherosclerosis and thrombosis. We 
      examined the relationship between severity of angina pectoris and its 
      accompanying characteristics and the risk of incident ischemic stroke. METHODS: 
      We traced 3122 patients with stable CHD, included in a secondary prevention trial 
      of lipid modification, the Bezafibrate Infarction Prevention trial. CHD was 
      documented by a history of myocardial infarction > or =6 months and < 5 years 
      before enrollment and/or stable angina pectoris with evidence of ischemia 
      confirmed by ancillary diagnostic testing. Severity of angina pectoris was 
      assessed according to the Canadian Cardiovascular Society angina classification, 
      and heart failure functional class according to the New York Heart Association 
      (NYHA) classification. Patients with severe heart failure or unstable angina on 
      enrollment were excluded. RESULTS: During a mean follow-up period of 8.2 years, 
      186 patients developed an ischemic stroke. The cumulative rate of ischemic stroke 
      increased in a dose-response manner from 4.7% in patients with no angina to 5.7%, 
      8.4%, and 12.9% in patients with angina classes 1, 2, and 3, respectively 
      (P<0.001). Patients with NYHA functional class 1 had a 5.5% rate of ischemic 
      stroke versus 7.3% and 9.6% in patients with classes 2 and 3, respectively 
      (P=0.05). In a Cox proportional-hazard model adjusting for conventional risk 
      factors and potential confounders, the hazard ratio associated with angina class 
      1 was 1.20 (95% CI, 0.83 to 1.74); class 2, 1.66 (95% CI, 1.12 to 2.45); and 
      class 3, 2.35 (95% CI, 1.08 to 5.13), as compared with patients with no angina. 
      Hazard ratios of ischemic stroke associated with conventional risk factors were 
      1.55 for a 10-year age increment, 2.16 for diabetes mellitus, 1.81 for current 
      smoking, and 1.29 for a 20 mm Hg increase in systolic blood pressure. 
      CONCLUSIONS: Severity of angina pectoris in patients with stable CHD predicts an 
      increased risk of subsequent ischemic stroke. The association between angina 
      class and incident ischemic stroke is independent of traditional vascular risk 
      factors.
FAU - Tanne, David
AU  - Tanne D
AD  - Neufeld Cardiac Research Center, Chaim Sheba Medical Center, Tel Hashomer, 
      Israel. tanne@post.tau.ac.il
FAU - Shotan, Avraham
AU  - Shotan A
FAU - Goldbourt, Uri
AU  - Goldbourt U
FAU - Haim, Moti
AU  - Haim M
FAU - Boyko, Valentina
AU  - Boyko V
FAU - Adler, Yehuda
AU  - Adler Y
FAU - Mandelzweig, Lori
AU  - Mandelzweig L
FAU - Behar, Solomon
AU  - Behar S
CN  - Bezafibrate Infarction Prevention Study Group
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Stroke
JT  - Stroke
JID - 0235266
SB  - IM
MH  - Aged
MH  - Angina Pectoris/complications/*diagnosis
MH  - Brain Ischemia/epidemiology/*etiology
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/diagnosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stroke/epidemiology/*etiology
EDAT- 2002/01/10 10:00
MHDA- 2002/02/02 10:01
CRDT- 2002/01/10 10:00
PHST- 2002/01/10 10:00 [pubmed]
PHST- 2002/02/02 10:01 [medline]
PHST- 2002/01/10 10:00 [entrez]
AID - 10.1161/hs0102.101630 [doi]
PST - ppublish
SO  - Stroke. 2002 Jan;33(1):245-50. doi: 10.1161/hs0102.101630.