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Journal of Neurology
Published in: Journal of Neurology 9/2020

01-09-2020 | Magnetic Resonance Imaging | Original Communication

Prevalence and risk factors of silent brain infarcts in patients with AF detected by 3T-MRI

Authors: Irene Escudero-Martínez, Rafael F. Ocete, Fernando Mancha, Ángela Vega, Pilar Piñero, Antonio López-Rueda, Elena Fajardo, Pilar Algaba, José Román Fernández-Engo, Eva M. Martín-Sánchez, Alejandro Galvao-Carmona, Elena Zapata-Arriaza, Lucía Lebrato, Blanca Pardo-Galiana, Juan Antonio Cabezas, María Irene Ayuso, Alejandro González, Francisco Moniche, Joan Montaner

Published in: Journal of Neurology | Issue 9/2020

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Abstract

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.
Appendix
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Metadata
Title
Prevalence and risk factors of silent brain infarcts in patients with AF detected by 3T-MRI
Authors
Irene Escudero-Martínez
Rafael F. Ocete
Fernando Mancha
Ángela Vega
Pilar Piñero
Antonio López-Rueda
Elena Fajardo
Pilar Algaba
José Román Fernández-Engo
Eva M. Martín-Sánchez
Alejandro Galvao-Carmona
Elena Zapata-Arriaza
Lucía Lebrato
Blanca Pardo-Galiana
Juan Antonio Cabezas
María Irene Ayuso
Alejandro González
Francisco Moniche
Joan Montaner
Publication date
01-09-2020
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 9/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-09887-0

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