| Authors |
Escudero-Martinez, Irene , Ocete, Rafael F. , Mancha, Fernando , Vega, Angela , Pinero, Pilar , Lopez-Rueda, Antonio , Fajardo, Elena , Algaba, Pilar , Fernandez-Engo, Jose Roman , Martin-Sanchez, Eva M. , GALVAO CARMONA, ALEJANDRO, Zapata-Arriaza, Elena , Lebrato, Lucia , Pardo-Galiana, Blanca , Cabezas, Juan Antonio , Ayuso, Maria Irene , Gonzalez, Alejandro , Moniche, Francisco , Montaner, Joan |
| Abstract |
Background Silent brain infarcts (SBI), a finding on neuroimaging, are\n associated with higher risk of future stroke. Atrial Fibrillation (AF)\n has been previously identified as a cause of SBI. Objectives The aim of\n this study is to determine the prevalence of and risk factors for SBI in\n patients with AF and low-to-moderate embolic risk according to CHADS(2)\n and CHA(2)DS(2)VASc score. Methods Patients with a history of AF based\n on medical records who scored 0-1 in the CHADS(2) score were selected\n from the Seville urban area using the Andalusian electronic healthcare\n database (DIRAYA). Demographic and clinical data were collected and a 3T\n brain MRI was performed on patients older than 50 years and with absence\n of neurological symptoms. Results 66 of the initial 443 patients (14.9%)\n and 41 of the 349 patients with low risk according to CHA(2)DS(2)VASc\n score (11.7%) presented at least 1 SBI. After adjusted multivariable\n analysis, an older age (OR 3.84, 95% CI 1.07-13.76) and left atrial (LA)\n enlargement (OR 3.13, 95% CI 1.15-8.55) were associated with SBI in the\n whole cohort, while only LA enlargement was associated with SBI in the\n low-risk cohort (OR 3.19, 95% CI 1.33-7.63). Conclusions LA enlargement\n on echocardiogram was associated with SBI in patients with AF and low or\n moderate embolic risk according to CHADS(2) and in the low-risk\n population according to CHA(2)DS(2)VASc. Although further studies are\n needed, a neuroimaging screening might be justified in these patients to\n guide medical therapies to improve stroke prevention. |
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