Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke

Stroke and myocardial infarction (MI) share common risk factors and pathological mechanisms, and coronary artery disease (CHD) is an important cause of death in patients with cerebrovascular disease. This Scientific Statement addresses issues in management of the relatively healthy patient with brain ischemia (a transient ischemic attack [TIA] or an ischemic stroke) who does not have recognized CHD but often has risk factors in addition to having had a TIA or stroke that indicate an increased likelihood of disability or death from cardiac disease in the future. This Statement should not be confused with the official American College of Cardiology (ACC)/American Heart Association (AHA) practice guidelines. The reader is referred to the ACC/AHA guidelines for management of recognized and symptomatic CHD1 and the American College of Chest Physicians (ACCP)2 and American Stroke Association (ASA)3–5 guidelines for evaluation of cardiac causes of TIA and stroke, which are important related but separate issues.