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Acute and subacute silent cerebral infarction in patients before elective coronary intervention

Publication at First Faculty of Medicine, Faculty of Medicine in Hradec Králové |
2018

Abstract

Introduction: The presence of silent cerebral infarction (SCI) might cause cognitive dysfunction, psychiatric disorders, stroke and earlier mortality. Exact incidence and prevalence of SCI is still not known, the results of previously published clinical trials vary.

The aims of our study were to detect acute and subacute SCI using MRI in patients before elective coronary intervention, measure the volume of SCI and investigate the risk factors associated with SCI. Materials and methods: Patients indicated for elective coronary angiography, angioplasty or stenting were enrolled in this study.

Brain MRI was performed before cardiac intervention. The presence of acute and subacute SCI was evaluated, SCI volume was measured and risk factors associated with SCI were investigated.

Cognitive functions were tested and correlated with SCI. Results: Between November 2015 and July 2017, 144 patients were enrolled in the study (103 men, 41 women).

At least one acute/subacute SCI was detected on MRI in 9 out of 144 (6.3%) patients before cardiac intervention. History of stroke or transient ischemic attack (TIA) was associated with a higher risk of SCI (p = 0.05).

Ipsilateral internal carotid artery stenosis > 50% was diagnosed in one patient. Patients with a history of stroke/TIA had a larger volume of SCI (p = 0.008).

We did not find stastistically significant differences in cognitive function tests between patients with SCI and without SCI (p > 0.05). Conclusion: Acute/subacute SCI was detected in 6.3% of patients indicated for elective coronary intervention.

History of stroke or TIA was a predictor of the presence of SCI and also its volume. No correlation was found between SCI and cognitive dysfunction.