Bahar M. Beaver, MD
Heldner MR, Li L, Lovett NG, Kubiak MM, Lyons S, Rothwell PM. Long-Term Prognosis of Patients With Transient Ischemic Attack or Stroke and Symptomatic Vascular Disease in Multiple Arterial Beds. Stroke. 2018
Patients with ischemic stroke or transient ischemic attack (TIA) due to intracranial atherosclerosis often have disease in other vascular territories within the body. As neurologists, we prescribe secondary preventive agents for these patients following a stroke, in hopes of decreasing their risk for future vascular events. In this article, Mirjam Heldner et al. set out to better delineate the relationship between atherosclerosis in other vascular beds and the intracerebral vasculature and how the number of vascular territories effected impacts patients’ overall risk of recurrent vascular events.
In a population-based study, the authors sampled patients from a pool of 92,728 patients in Oxfordshire, United Kingdom (part of the OXVASC study) who had a stroke or TIA from 2000 to 2014. The authors investigated patients who had symptomatic disease in their coronary and/or peripheral vasculature in addition to their stroke/TIA. Additionally, they compared atherosclerotic risk factors (hypertension, hypercholesterolemia, diabetes, smoking) among patients and correlated these with the severity of systemic vascular disease. These patients underwent thorough clinical evaluation and were followed up at 1, 6, 12, 60, and 120 months for identification of any further vascular events. Statistical analysis compared the number of atherosclerotic risk factors to the number of vascular territories affected, as well as the rate of recurrence or prevalence of symptomatic vascular disease.