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Silent brain infarction and coronary artery disease in Japanese patients
H Tanaka1, K Sueyoshi, M Nishino
1First Department of Internal Medicine, Osaka Rosai Hospital, Japan.
Insights
Silent brain infarction is linked to advanced coronary atherosclerosis and older age. These findings highlight the importance of managing heart disease risk factors to prevent silent strokes in the elderly.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Silent brain infarction (SBI) is prevalent in the elderly, but its predictive factors remain unclear.
- Understanding these factors is crucial for early detection and prevention strategies.
- Ischemic heart disease (IHD) and cerebrovascular risk factors are investigated as potential contributors to SBI.
Purpose of the Study:
- To investigate the association between ischemic heart disease, cerebrovascular risk factors, and the occurrence of silent brain infarction.
- To identify key predictors of silent brain infarction in patients with suspected ischemic heart disease.
Main Methods:
- A cohort of 92 Japanese patients with suspected ischemic heart disease was studied.
- Coronary atherosclerosis severity (stenosis, Gensini score) and carotid atherosclerosis were assessed.
- Silent brain infarctions were detected via computed tomography; cerebrovascular risk factors were also evaluated.
Main Results:
- Patients with silent brain infarction were significantly older and had more extensive coronary atherosclerosis.
- The frequency of silent brain infarction correlated positively with the severity of coronary artery stenosis.
- No significant differences in carotid atherosclerosis or common cerebrovascular risk factors (hypertension, diabetes, smoking, etc.) were observed between groups.
Conclusions:
- Coronary atherosclerosis and advanced age are identified as significant risk factors for silent brain infarction.
- These findings underscore the importance of managing coronary artery disease in preventing silent brain infarction.
Objective:
Silent brain infarction is fairly common in the elderly, but predictive factors have not been definitively established. This study focuses attention on ischemic heart disease and cerebrovascular risk factors about the frequency of silent brain infarction.
Design:
The existence of silent brain infarction, the extent of coronary artery stenosis, and cerebrovascular risk factors of consecutive 92 case series with suspected ischemic heart disease were surveyed.
Setting:
A hospital for patients with ischemic heart disease.
Patients:
Ninety-two consecutive Japanese patients with suspected ischemic heart disease were recruited.
Main Outcome Measures:
All subjects were evaluated for coronary atherosclerosis (number of coronary arteries with significant stenosis and Gensini score), the number of silent brain infarctions detected by computed tomography, the extent of carotid atherosclerosis as determined by B-mode ultrasonography, and cerebrovascular risk factors.
Results:
Patients with silent cerebral infarctions were older (66.2 +/- 10.4 years) than those without such events (60.1 +/- 8.8 years) (P < .01). The extent of coronary atherosclerosis in patients with silent cerebral infarctions was significantly greater than in those without such events after adjustment for the effect of age (P < .001). The extent of carotid atherosclerosis and the percentages of individuals with hypertension, diabetes mellitus, a smoking habit, hypercholesterolemia, hypertriglyceridemia, and a low serum high-density lipoprotein cholesterol level did not differ between the groups with and without silent brain infarction. The frequency of silent brain infarction increased with the severity of coronary stenosis.
Conclusion:
Coronary atherosclerosis and age were important risk factors for silent brain infarction.