Multiple Silent Lacunes Are Associated with Recurrent Ischemic Stroke.

Area of Science:

• Neurology
• Neuroimaging
• Stroke Medicine

Background:

• Silent lacunes are common incidental findings in ischemic stroke patients.
• Their prognostic value regarding future cardiovascular events remains unclear.
• This study investigates silent lacunes in ischemic stroke patients without atrial fibrillation (AF).

Purpose of the Study:

• To determine the association between silent lacunes and the risk of ischemic stroke recurrence.
• To evaluate the impact of silent lacunes on mortality and cardiovascular events.
• To analyze these associations in a cohort of ischemic stroke patients excluding those with AF.

Main Methods:

• A registry-based observational cohort study included 786 patients with first-ever ischemic stroke.
• Silent lacunes were assessed via brain MRI (none, single, multiple).
• Cox proportional hazard models were used to calculate adjusted hazard ratios (HRs) for outcomes, with follow-up for stroke recurrence or death.

Main Results:

• Multiple silent lacunes were present in 11.1% of patients.
• Increasing numbers of silent lacunes correlated with higher incidence rates of ischemic stroke recurrence.
• Adjusted HR for recurrence was 2.52 (1.25-5.09) for multiple silent lacunes; no significant association found for death or cardiovascular events.

Conclusions:

• In ischemic stroke patients without AF, more silent lacunes are linked to a higher risk of stroke recurrence.
• Multiple silent lacunes significantly increase the risk of recurrent ischemic stroke.
• Silent lacunes did not significantly affect the risk of death or cardiovascular events in this cohort.