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European Heart Journal Advance Access originally published online on June 3, 2008
European Heart Journal 2008 29(13):1605-1607; doi:10.1093/eurheartj/ehn232
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Stroke is a coronary heart disease risk equivalent: implications for future clinical trials in secondary stroke prevention

Pierre Amarenco1,2,* and Philippe Gabriel Steg1,3

1 INSERM U-698 and Denis Diderot University—Paris VII, France
2 Department of Neurology and Stroke Centre, Bichat-Claude Bernard University Hospital, 46 rue Henri Huchard, 75018 Paris, France
3 Department of Cardiology, Bichat-Claude Bernard University Hospital, Paris, France

Received 1 September 2007; revised 6 May 2008; accepted 15 May 2008; online publish-ahead-of-print 3 June 2008.

* Corresponding author. Tel: +33 1 4025 8726, Fax: +33 1 4025 7198, Email: pierre.amarenco@bch.aphp.fr

The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology.

The first 10% of the full text of this article appears below.

With an estimated 1 million cases per year in Europe, 1.2 million in North America, and 10 millions in the rest of the world, the burden of stroke is enormous. Stroke includes brain haemorrhage, transient ischaemic attacks (TIAs), and cerebral (brain) infarction (each of these causes accounting for approximately 15, 15, and 70% of cases, respectively).1,2 Overall, a quarter of all stroke patients has a history of a symptomatic coronary event.3 These patients are prone to recurrent coronary heart disease (CHD) events. In the PROGRESS trial, in the subset of patients with recent stroke and a history of CHD, the risk of a . . . [Full Text of this Article]


   After a stroke/transient ischaemic attack, patients are at high risk of short-term non-fatal stroke and of long-term fatal coronary heart disease
 

   Coronary heart disease is highly prevalent at autopsy in patients with stroke/transient ischaemic attack
 

   Recent studies confirmed 10-year incidence of coronary heart disease in patients with stroke/transient ischaemic attack is 20%
 

   Secondary prevention trials should not only focus on the first 2–3 years
 

   Two long-term (4–5 years) secondary prevention trials showed reduction in coronary heart disease events
 

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