Purpose: To investigate the prevalence of cervical and intracranial atherosclerosis and silent brain infarction in patients with coronary artery disease (CAD). Methods: Cervical and intracranial atherosclerotic lesions on magnetic resonance angiography (MRA) and silent brain infarctions on magnetic resonance imaging (MRI) were investigated in comparison with the findings of coronary angiography in 133 consecutive patients with CAD. Results: The mean severity scores of cervical and intracranial MRA lesions were significantly higher in the three-vessel CAD (0.40 and 0.53, respectively) than in the zero-vessel CAD group (0.04 and 0.11). The mean scores of the maximal size and multiplicity of MRI lesion were also significantly greater in the two-vessel (1.00 and 1.44) and three-vessel CAD (0.94 and 1.26) than in the zero-vessel CAD group (0.27 and 0.50). The incidence of MRA lesion was markedly higher in patients with brain MRI lesion than in those without (51.1 vs. 6.5%). Conclusions: Serious coronary artery lesions were commonly accompanied by latent atherosclerotic lesions in the cervical and intracranial arteries besides silent brain infarction in patients with CAD.

1.
Tanaka H, Sueyoshi K, Nishino M, Ishida M, Fukunaga R, Abe H: Silent brain infarction and coronary artery disease in Japanese patients. Arch Neurol 1993;50:706–709.
2.
Uehara T, Tabuchi M, Hayashi T, Kurogane H, Yamadori A: Asymptomatic occlusive lesions of carotid and intracranial arteries in Japanese patients with ischemic heart disease. Evaluation by brain magnetic resonance angiography. Stroke 1996;27:393–397.
3.
Nishimaru K, McHenry LC Jr, Toole JF: Cerebral angiographic and clinical differences in carotid system transient ischemic attacks between American Caucasian and Japanese patients. Stroke 1984;15:56–59.
4.
Caplan LR, Gorelick PB, Hier DB: Race, sex and occlusive cerebrovascular disease: A review. Stroke 1986;17:648–655.
5.
Mathur KS, Kashyap SK, Kumar V: Correlation of the extent and severity of atherosclerosis in the coronary and cerebral arteries. Circulation 1963;27:929–934.
6.
Holme I, Enger SC, Helgeland A, Hjermann I, Leren P, Lund-Larsen PG, Solberg LA, Strong JP: Risk factors and raised atherosclerotic lesions in coronary and cerebral arteries. Statistical analysis from the Oslo study. Arteriosclerosis 1981;1:250–256.
7.
Kobayashi S, Okada K, Koide H, Bokura H, Yamaguchi S: Subcortical silent brain infarction as a risk factor for clinical stroke. Stroke 1997;28:1932–1939.
8.
Kruskal WH, Wallis WA: Use of ranks in one-criterion variance analysis. J Am Stat Assoc 1952;47:583–621.
9.
Scheffé H: A method for judging all contrasts in the analysis of variance. Biometrika 1953;40:87–104.
10.
Mantel N: Chi-square tests with one degree of freedom: Extension of the Mantel-Haenszel procedure. J Am Stat Assoc 1963;58:690–700.
11.
Randles RH, Wolfe DA: Linear rank statistics under the null hypothesis; in Randles RH, Wolfe DA (eds): Introduction of the Theory of Nonparametric Statistics. Melbourne, Krieger, 1991, pp 251–289.
12.
Sanguigni V, Gallu M, Strano A: Incidence of carotid artery atherosclerosis in patients with coronary artery disease. Angiology 1993;44:34–38.
13.
Mittl RL Jr, Broderick M, Carpenter JP, Goldberg HI, Listerud J, Mishkin MM, Berkowitz HD, Atlas SW: Blinded-reader comparison of magnetic resonance angiography and duplex ultrasonography for carotid artery bifurcation stenosis. Stroke 1994;25:4–10.
14.
Uehara T, Mori E, Tabuchi M, Ohsumi Y, Yamadori A: Detection of occlusive lesion in intracranial arteries by three-dimensional time-of-flight magnetic resonance angiography. Cerebrovasc Dis 1994;4:365–370.
15.
Özeren A, Acartürk E, Koç F, Demir M, Sarica Y, Eroglu H: Silent cerebral lesions on magnetic resonance imaging in subjects with coronary artery disease. Jpn Heart J 1998;39:611–618.
16.
Hara M, Ito K, Nawata T, Shiraiwa H, Urakami S, Tsunematsu Y, Kusakabe T, Ooga M, Niwa H, Maeda T, Saikawa T, Sakata T: Silent cerebral infarction associated with coronary artery disease. Cardiology 1994;85:171–174.
17.
Modrego Pardo PJ, Labrador Fuster T, Torres Nuez J: Silent brain infarctions in patients with coronary heart diseases. A Spanish population survey. J Neurol 1998;245:93–97.
18.
Sidhu PS, Naoumova RP, Maher VM, MacSweeney JE, Neuwirth CK, Hollyer JS, Thompson GR: The extracranial carotid artery in familial hypercholesterolaemia: Relationship of intimal-medial thickness and plaque morphology with plasma lipids and coronary heart disease. J Cardiovasc Risk 1995;3:61–67.
19.
Shinkawa A, Ueda K, Kiyohara Y, Kato I, Sueishi K, Tsuneyoshi M, Fujishima M: Silent cerebral infarction in a community-based autopsy series in Japan. The Hisayama study. Stroke 1995;26:380–385.
20.
Handa N, Matsumoto M, Maeda H, Hougaku H, Ogawa S, Fukunaga R, Yoneda S, Kimura K, Kamada T: Ultrasonic evaluation of early carotid atherosclerosis. Stroke 1990;21:1567–1572.
21.
Ferrannini E, Haffner SM, Mitchell BD, Stern MP: Hyperinsulinaemia: The key feature of a cardiovascular and metabolic syndrome. Diabetologia 1991;34:416–422.
22.
Lebovitz HE: Effects of oral antihyperglycemic agents in modifying macrovascular risk factors in type 2 diabetes. Diabetes Care 1999;22(suppl 3):C41–C44.
23.
Kase CS, Wolf PA, Chodosh EH, Zacker HB, Kelly-Hayes M, Kannel WB, D’Agostino RB, Scampini L: Prevalence of silent stroke in patients presenting with initial stroke: The Framingham study. Stroke 1989;20:850–852.
24.
Breckenridge A: Hypertension and hyperuricemia. Lancet 1966;i:15–18.
25.
Abbott RD, Brand FN, Kannel WB, Castelli WP: Gout and coronary heart disease: The Framingham study. J Clin Epidemiol 1988;41:237–242.
26.
Hines GL, Scott WC, Schubach SL, Kofsky E, Wehbe U, Cabasino E: Prophylactic carotid endarterectomy in patients with high-grade carotid stenosis undergoing coronary bypass: Does it decrease the incidence of perioperative stroke? Ann Vasc Surg 1998;12:23–27.
27.
The European Carotid Surgery Trialists Collaborative Group: Risk of stroke in the distribution of an asymptomatic carotid artery. Lancet 1995;345:209–212.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.