Prevalence and risk factors of silent brain infarcts in patients with AF detected by 3T-MRI
| Autor: | Rafael F. Ocete, Ángela Vega, Alejandro González, Francisco Moniche, Eva María Martín-Sánchez, Joan Montaner, Pilar Piñero, Irene Escudero-Martínez, Blanca Pardo-Galiana, José Román Fernández-Engo, María Irene Ayuso, Juan Antonio Cabezas, Elena Fajardo, Alejandro Galvao-Carmona, Lucía Lebrato, Fernando Mancha, Elena Zapata-Arriaza, Antonio López-Rueda, Pilar Algaba |
|---|---|
| Přispěvatelé: | Ministerio de Economía y Competitividad (España), Junta de Andalucía, Fundación Cajasol, Red Española de Investigación en Patología Infecciosa, Spanish Neurovascular Network |
| Rok vydání: | 2020 |
| Předmět: |
Brain Infarction
medicine.medical_specialty Neurology Population 03 medical and health sciences 0302 clinical medicine Neuroimaging Risk Factors Internal medicine medicine Prevalence Humans 030212 general & internal medicine cardiovascular diseases education Stroke Silent brain infarction Neuroradiology Aged education.field_of_study business.industry Medical record Atrial fibrillation medicine.disease Magnetic Resonance Imaging Cohort cardiovascular system Neurology (clinical) business 030217 neurology & neurosurgery MRI |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| ISSN: | 1432-1459 0340-5354 |
| Popis: | [Background] Silent brain infarcts (SBI), a finding on neuroimaging, are associated with higher risk of future stroke. Atrial Fibrillation (AF) has been previously identified as a cause of SBI. [Objectives] The aim of this study is to determine the prevalence of and risk factors for SBI in patients with AF and low-to-moderate embolic risk according to CHADS2 and CHA2DS2VASc score. [Methods] Patients with a history of AF based on medical records who scored 0–1 in the CHADS2 score were selected from the Seville urban area using the Andalusian electronic healthcare database (DIRAYA). Demographic and clinical data were collected and a 3T brain MRI was performed on patients older than 50 years and with absence of neurological symptoms. [Results] 66 of the initial 443 patients (14.9%) and 41 of the 349 patients with low risk according to CHA2DS2VASc score (11.7%) presented at least 1 SBI. After adjusted multivariable analysis, an older age (OR 3.84, 95% CI 1.07–13.76) and left atrial (LA) enlargement (OR 3.13, 95% CI 1.15–8.55) were associated with SBI in the whole cohort, while only LA enlargement was associated with SBI in the low-risk cohort (OR 3.19, 95% CI 1.33–7.63). [Conclusions] LA enlargement on echocardiogram was associated with SBI in patients with AF and low or moderate embolic risk according to CHADS2 and in the low-risk population according to CHA2DS2VASc. Although further studies are needed, a neuroimaging screening might be justified in these patients to guide medical therapies to improve stroke prevention. The Spanish Ministry of Economy, Industry and Competitiveness (Grant RTC-2016-5300-1), the Junta de Andalucía (Grant PIN-0144-2016) and the European Project ITRIBIS supported the study. The Fundación Cajasol also contributed to the study. Neurovascular Research Group is part of the Spanish Neurovascular Disease Research Network (INVICTUS + , RD16/0019/0015). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink