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Acute Myocardial Infarction in Rats
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Association Between Unrecognized Myocardial Infarction and Cerebral Infarction on Magnetic Resonance Imaging.

Alexander E Merkler1,2, Sigurdur Sigurdsson3, Gudny Eiriksdottir3

  • 1Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, New York.

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Summary

Unrecognized myocardial infarction (MI), detected by cardiac MRI, is associated with an increased risk of cerebral infarction. This finding suggests that silent heart attacks may be a novel risk factor for stroke.

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Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • The association between unrecognized myocardial infarction (MI) and cerebral infarction remains uncertain.
  • Cardiac magnetic resonance imaging (MRI) can detect evidence of MI without a prior clinical diagnosis.

Purpose of the Study:

  • To investigate the association between unrecognized MI, identified via cardiac MRI, and the presence of cerebral infarction.
  • To determine if unrecognized MI is a risk factor for stroke, particularly embolic infarcts of undetermined source.

Main Methods:

  • A cross-sectional study was conducted on a community-dwelling cohort of older Icelandic individuals (aged 67-93 years).
  • Participants underwent both brain MRI and cardiac MRI with late gadolinium enhancement.
  • Unrecognized MI was defined as cardiac MRI evidence of MI without a history of clinically recognized MI. Cerebral infarctions were identified on brain MRI.

Main Results:

  • Among 925 participants, 153 (16.5%) had unrecognized MI and 308 (33.3%) had cerebral infarction.
  • Unrecognized MI was associated with a 1.5-fold increased likelihood of cerebral infarction (OR, 1.5; 95% CI, 1.02-2.2; P=.04) after adjustment for confounders.
  • Unrecognized MI was also linked to embolic infarcts of undetermined source (OR, 2.0; 95% CI, 1.1-3.5; P=.02).

Conclusions:

  • Unrecognized myocardial infarction detected by cardiac MRI is associated with cerebral infarction in a population-based sample.
  • These findings highlight unrecognized MI as a potential novel risk factor for cardiac embolism and subsequent cerebral infarction.
  • Further research may elucidate the mechanisms linking silent MI to stroke risk.