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Escudero-Martínez, Irene; Ocete, Rafael F.; Mancha, Fernando; Vega, Ángela; Piñero, Pilar; López-Rueda, Antonio; Fajardo, Elena; Algaba, Pilar; Fernández-Engo, José Román; Martín-Sánchez, Eva M.; Galvao-Carmona, Alejandro; Zapata-Arriaza, Elena; Lebrato, Lucía; Pardo-Galiana, Blanca; Cabezas, Juan Antonio; Ayuso, María Irene; González, Alejandro; Moniche, Francisco; Montaner, Joan
Journal of neurology, 09/2020, Letnik: 267, Številka: 9Journal Article
Background Silent brain infarcts (SBI), a finding on neuroimaging, are associated with higher risk of future stroke. Atrial Fibrillation (AF) has been previously identified as a cause of SBI. Objectives The aim of this study is to determine the prevalence of and risk factors for SBI in patients with AF and low-to-moderate embolic risk according to CHADS 2 and CHA 2 DS 2 VASc score. Methods Patients with a history of AF based on medical records who scored 0–1 in the CHADS 2 score were selected from the Seville urban area using the Andalusian electronic healthcare database (DIRAYA). Demographic and clinical data were collected and a 3T brain MRI was performed on patients older than 50 years and with absence of neurological symptoms. Results 66 of the initial 443 patients (14.9%) and 41 of the 349 patients with low risk according to CHA 2 DS 2 VASc score (11.7%) presented at least 1 SBI. After adjusted multivariable analysis, an older age (OR 3.84, 95% CI 1.07–13.76) and left atrial (LA) enlargement (OR 3.13, 95% CI 1.15–8.55) were associated with SBI in the whole cohort, while only LA enlargement was associated with SBI in the low-risk cohort (OR 3.19, 95% CI 1.33–7.63). Conclusions LA enlargement on echocardiogram was associated with SBI in patients with AF and low or moderate embolic risk according to CHADS 2 and in the low-risk population according to CHA 2 DS 2 VASc. Although further studies are needed, a neuroimaging screening might be justified in these patients to guide medical therapies to improve stroke prevention.
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Dostop do baze podatkov JCR je dovoljen samo uporabnikom iz Slovenije. Vaš trenutni IP-naslov ni na seznamu dovoljenih za dostop, zato je potrebna avtentikacija z ustreznim računom AAI.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Vir: Osebne bibliografije
in: SICRIS
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