Acute and subacute silent cerebral infarction in patients before elective coronary intervention

Czech version

Authors: D. Viszlayová ^1,2,3; D. Školoudík ^4,5; M. Brozman ¹; K. Langová ^5,6; R. Herzig ⁷; L. Pátrovič ⁸; S. Királová ⁹
Authors‘ workplace: Neurologická klinika FSVaZ UKF a FN Nitra ¹; Neurologická klinika LF UP, Olomouc ²; Neurologická klinika LF UK, Hradec Králové ³; Neurologická klinika 1. LF UK a VFN v Praze ⁴; Centrum vědy a výzkumu, FZV UP, Olomouc ⁵; Ústav lekářské biofyziky, LF UP, Olomouc ⁶; Komplexní cerebrovaskulární centrum, Neurologická klinika LF UK a FN Hradec Králové ⁷; Jessenius – diagnostické centrum a. s., Nitra ⁸; Ústav klinickej psychológie, FN Nitra ⁹
Published in: Cesk Slov Neurol N 2018; 81(5): 563-569
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2018563

Overview

Introduction:
The presence of silent cerebral infarction (SCI) might cause cognitive dysfunction, psychiatric disorders, stroke and earlier mortality. Exact incidence and prevalence of SCI is still not known, the results of previously published clinical trials vary. The aims of our study were to detect acute and subacute SCI using MRI in patients before elective coronary intervention, measure the volume of SCI and investigate the risk factors associated with SCI.

Materials and methods:
Patients indicated for elective coronary angiography, angioplasty or stenting were enrolled in this study. Brain MRI was performed before cardiac intervention. The presence of acute and subacute SCI was evaluated, SCI volume was measured and risk factors associated with SCI were investigated. Cognitive functions were tested and correlated with SCI.

Results:
Between November 2015 and July 2017, 144 patients were enrolled in the study (103 men, 41 women). At least one acute/ subacute SCI was detected on MRI in 9 out of 144 (6.3%) patients before cardiac intervention. History of stroke or transient ischemic attack (TIA) was associated with a higher risk of SCI (p = 0.05). Ipsilateral internal carotid artery stenosis > 50% was diagnosed in one patient. Patients with a history of stroke/ TIA had a larger volume of SCI (p = 0.008). We did not find stastistically significant differences in cognitive function tests between patients with SCI and without SCI (p > 0.05).

Conclusion:
Acute/ subacute SCI was detected in 6.3% of patients indicated for elective coronary intervention. History of stroke or TIA was a predictor of the presence of SCI and also its volume. No correlation was found between SCI and cognitive dysfunction.

Key words:
silent cerebral infarction – magnetic resonance imaging – stroke – coronary angiography – cognitive deficit

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

选择性冠状动脉介入治疗前患者急性和亚急性无症状脑梗死

介绍：

无症状脑梗塞（SCI）的存在可能导致认知功能障碍，精神疾病，中风和早期死亡。 SCI的确切发病率和患病率尚不清楚，以前发表的临床试验结果各不相同。我们的研究目的是在选择性冠状动脉介入治疗前使用MRI检测急性和亚急性脊髓损伤，测量脊髓损伤的体积并调查与SCI相关的危险因素。

材料和方法：

选择性冠状动脉造影，血管成形术或支架置入术的患者参加了本研究。在心脏介入前进行脑MRI检查。评估急性和亚急性SCI的存在，测量SCI体积并研究与SCI相关的风险因素。测试认知功能并与SCI相关联。

结果：

2015年11月至2017年7月期间，共有144名患者参加了该研究（103名男性，41名女性）。在心脏介入治疗前144例患者中有9例（6.3％）在MRI上检测到至少一例急性/亚急性SCI。中风或短暂性脑缺血发作（TIA）的病史与SCI的高风险相关（p = 0.05）。一名患者诊断出同侧颈内动脉狭窄> 50％。有卒中/TIA病史的患者脊髓损伤量较大（p = 0.008）。我们没有发现SCI患者和没有SCI患者的认知功能测试存在显著差异（p> 0.05）。

结论：

在选择性冠状动脉介入治疗的6.3％患者中检测到急性/亚急性SCI。中风或TIA的病史是SCI存在及其体积的预测因子。 SCI与认知功能障碍之间未发现相关性。

关键词：

无症状脑梗塞 - 磁共振成像 - 中风 - 冠状动脉造影 - 认知缺陷

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