Coronary artery disease (CAD) together with stroke are the leading causes of death worldwide, and together, they pre-sent a health and economic burden. Ischemic stroke survivors and patients who suffered transient ischemic attack (TIA) have a higher prevalence of coronary atherosclerosis, and they have a relatively high risk of myocardial infarcti-on and nonstroke vascular death. Pubmed was searched for studies focused on investigating coronary atherosclerosis in ischemic stroke survivors or patients who suffered TIA and their cardiovascular risk assessment. There were corona-ry plaques in 48%-70% of stroke survivors without a known history of CAD, and significant stenosis of at least one coronary artery can be found in 31% of these patients. CAD is a major cause of morbidity and mortality in stroke survivors. Detection and treatment of silent CAD may improve the long-term outcome and survival of these patients.

Department of Cardiology 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady; Prague Czech Republic

Anatol J Cardiol. 2021 Mar;25(3):151. doi: 10.5152/AnatolJCardiol.2021.3. PubMed

Anatol J Cardiol. 2021 Jul;25(7):525-526. doi: 10.5152/AnatolJCardiol.2021.245. PubMed

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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation. 2020;141:e139–596. doi: 10.1161/CIR.0000000000000746. PubMed DOI

Touzé E, Varenne O, Chatellier G, Peyrard S, Rothwell PM, Mas JL. Risk of myocardial infarction and vascular death after transient ischemic attack and ischemic stroke: a systematic review and meta-analysis. Stroke. 2005;36:2748–55. doi: 10.1161/01.STR.0000190118.02275.33. PubMed DOI

Rokey R, Rolak LA, Harati Y, Kutka N, Verani MS. Coronary artery disease in patients with cerebrovascular disease: a prospective study. Ann Neurol. 1984;16:50–3. doi: 10.1002/ana.410160110. PubMed DOI

Love BB, Grover-McKay M, Biller J, Rezai K, McKay CR. Coronary artery disease and cardiac events with asymptomatic and symptomatic cerebrovascular disease. Stroke. 1992;23:939–45. doi: 10.1161/01.STR.23.7.939. PubMed DOI

Kannel WB. Risk factors for atherosclerotic cardiovascular outcomes in different arterial territories. J Cardiovasc Risk. 1994;1:333–9. doi: 10.1097/00043798-199412000-00009. PubMed DOI

Amarenco P, Lavallée PC, Labreuche J, Ducrocq G, Juliard JM, Feldman L, et al. Prevalence of coronary atherosclerosis in patients with cerebral infarction. Stroke. 2011;42:22–9. doi: 10.1161/STROKEAHA.110.584086. PubMed DOI

Yoo J, Yang JH, Choi BW, Kim YD, Nam HS, Choi HY, et al. The frequency and risk of preclinical coronary artery disease detected using multichannel cardiac computed tomography in patients with ischemic stroke. Cerebrovasc Dis. 2012;33:286–94. doi: 10.1159/000334980. PubMed DOI

Gongora-Rivera F, Labreuche J, Jaramillo A, Steg PG, Hauw JJ, Amarenco P. Autopsy prevalence of coronary atherosclerosis in patients with fatal stroke. Stroke. 2007;38:1203–10. doi: 10.1161/01.STR.0000260091.13729.96. PubMed DOI

Calvet D, Touzé E, Varenne O, Sablayrolles JL, Weber S, Mas JL. Prevalence of asymptomatic coronary artery disease in ischemic stroke patients: the PRECORIS study. Circulation. 2010;121:1623–9. doi: 10.1161/CIRCULATIONAHA.109.906958. PubMed DOI

Hoshino A, Nakamura T, Enomoto S, Kawahito H, Kurata H, Nakahara Y, et al. Prevalence of coronary artery disease in Japanese patients with cerebral infarction: impact of metabolic syndrome and intracranial large artery atherosclerosis. Circ J. 2008;72:404–8. doi: 10.1253/circj.72.404. PubMed DOI

Seo WK, Yong HS, Koh SB, Suh SI, Kim JH, Yu SW, et al. Correlation of coronary artery atherosclerosis with atherosclerosis of the intracranial cerebral artery and the extracranial carotid artery. Eur Neurol. 2008;59:292–8. doi: 10.1159/000121418. PubMed DOI

Di Pasquale G, Andreoli A, Pinelli G, Grazi P, Manini G, Tognetti F, et al. Cerebral ischemia and asymptomatic coronary artery disease: a prospective study of 83 patients. Stroke. 1986;17:1098–101. doi: 10.1161/01.STR.17.6.1098. PubMed DOI

Kim JG, Lee SJ, Choi H, Choi YJ, Lee BH. Silent Coronary Artery Disease in Symptomatic Candidates for Carotid Revascularization Intervention. Eur Neurol. 2016;76:69–74. doi: 10.1159/000447945. PubMed DOI

Enomoto Y, Yoshimura S, Yamada K, Kawasaki M, Nishigaki K, Minatoguchi S, et al. Silent coronary artery disease in Japanese patients undergoing carotid artery stenting. J Stroke Cerebrovasc Dis. 2013;22:1163–8. doi: 10.1016/j.jstrokecerebrovasdis.2012.12.013. PubMed DOI

Hofmann R, Kypta A, Steinwender C, Kerschner K, Grund M, Leisch F. Coronary angiography in patients undergoing carotid artery stenting shows a high incidence of significant coronary artery disease. Heart. 2005;91:1438–41. doi: 10.1136/hrt.2004.050906. PubMed DOI PMC

Hertzer NR, Young JR, Beven EG, Graor RA, O’Hara PJ, Ruschhaupt WF, 3rd, et al. Coronary angiography in 506 patients with extracranial cerebrovascular disease. Arch Intern Med. 1985;145:849–52. doi: 10.1001/archinte.1985.00360050105017. PubMed DOI

Sulženko J, Paluszek P, Machnik R, Widimský P, Jarkovský J, Pieniazek P. Prevalence and predictors of coronary artery disease in patients undergoing carotid artery stenting. Coron Artery Dis. 2019;30:204–10. doi: 10.1097/MCA.0000000000000695. PubMed DOI

Amarenco P, Bogousslavsky J, Callahan A, 3rd, Goldstein LB, Hennerici M, Rudolph AE, et al. Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549–59. doi: 10.1056/NEJMoa061894. PubMed DOI

Dhamoon MS, Sciacca RR, Rundek T, Sacco RL, Elkind MS. Recurrent stroke and cardiac risks after first ischemic stroke: the Northern Manhattan Study. Neurology. 2006;66:641–6. doi: 10.1212/01.wnl.0000201253.93811.f6. PubMed DOI

Adams RJ, Chimowitz MI, Alpert JS, Awad IA, Cerqueria MD, Fayad P, et al. Stroke Council and the Council on Clinical Cardiology of the American Heart Association; American Stroke Association. Coronary risk evaluation in patients with transient ischemic attack and ischemic stroke: a scientific statement for healthcare professionals from the Stroke Council and the Council on Clinical Cardiology of the American Heart Association/American Stroke Association. Circulation. 2003;108:1278–90. doi: 10.1161/01.CIR.0000090444.87006.CF. PubMed DOI