Silent Myocardial Ischemia
Common in Stroke, TIA Patients
More than half of patients with symptomatic intracranial atherosclerosis have silent myocardial ischemia. A group of 65 patients with a first-ever transient ischemic attack (TIA) or ischemic stroke underwent maximal-stress myocardial perfusion single-photon emission computed
tomography (SPECT). Reversible myocardial perfusion defects occurred in 34 (52%) patients. Risk factors associated with a pathologic SPECT included elevated total cholesterol, lipoprotein(a), and homocysteine levels. Having a stenosed intracranial internal carotid
artery and the symptomatic stenosis being located in vertebrobasilar arteries
were independently associated with silent myocardial ischemia after accounting
for other risk factors (Stroke.2005;36:1201-1206).