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Incidence and Predictors of Catheterization-Related Cerebral Infarction on Diffusion-Weighted Magnetic Resonance
Yusuke Morita1, Takao Kato1, Mitsumasa Okano1
1Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka 530-8480, Japan.
Abstract:
Introduction. The aim of this study was to examine the incidence and risk factors of catheterization-related CI in the contemporary era, using diffusion-weighted magnetic resonance imaging. Methods. We retrospectively analyzed consecutive 84 patients who underwent MRI (magnetic resonance imaging) after 2.81 ± 2.4 days (mean ± SD) of catheterization via aortic arch. We categorized the patients by the presence or absence of acute CI determined by diffusion-weighted MRI and analyzed the incidence and predictors. Results. Of 84 patients that underwent MRI after catheterization, acute CI was determined in 27 (32.1%) patients. In univariate analysis, dyslipidemia, age, coronary artery disease, antiplatelet agents, number of catheters used, urgent settings, and interventional procedures were significantly different. Multivariate analysis revealed dyslipidemia (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.41-16.03; p = 0.01), higher age (OR, 1.09; 95% CI, 1.007-1.19; p = 0.03), and the number of catheters used (OR, 2.21; 95% CI, 1.21-4.36; p = 0.01) as independent predictors of the incidence of catheterization-related acute CI. Conclusions. Dyslipidemia, higher age, and number of catheters used were independent predictors for acute CI after catheterization. These findings imply that managing dyslipidemia and comprehensive planning to minimize the numbers of catheters are important.
Insights
Catheterization-related cardiac injury (CI) affects 32.1% of patients. Key predictors include dyslipidemia, advanced age, and multiple catheters used, highlighting the need for risk factor management.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Catheterization procedures carry a risk of cardiac injury (CI).
- Diffusion-weighted magnetic resonance imaging (DW-MRI) offers advanced visualization for detecting acute CI.
- Understanding contemporary incidence and risk factors is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of catheterization-related CI.
- To identify independent predictors of acute CI using DW-MRI.
- To inform strategies for reducing CI in patients undergoing catheterization.
Main Methods:
- Retrospective analysis of 84 patients undergoing aortic arch catheterization.
- Use of diffusion-weighted MRI to diagnose acute CI post-catheterization (mean 2.81 days).
- Univariate and multivariate analyses to identify risk factors for CI.
Main Results:
- Acute CI was detected in 32.1% of patients (27 out of 84).
- Independent predictors identified: dyslipidemia (OR 4.46), higher age (OR 1.09), and number of catheters used (OR 2.21).
- Factors like coronary artery disease and antiplatelet use were significant in univariate but not multivariate analysis.
Conclusions:
- Dyslipidemia, older age, and increased catheter use are significant predictors of catheterization-related CI.
- Managing dyslipidemia and minimizing catheter use are vital for preventing CI.
- DW-MRI is effective in diagnosing acute CI in the context of catheterization.
