Aspirin Attenuates the Incidence of Silent Brain Lesions in Patients With Nonvalvular Atrial Fibrillation

Abstract

Background Abnormal findings, including silent cerebral infarction, are frequently observed by magnetic resonance imaging (MRI) in patients with nonvalvular atrial fibrillation (NVAF); however, the prevalence and prevention strategy for these lesions have not been extensively studied. In the present study the preventive effects of aspirin on silent ischemic lesions was investigated. Methods and Results Silent lesions were counted using cranial MRI performed in 78 neurologically normal adults with sinus rhythm and in 212 patients with NVAF without a history of stroke. MRIs were repeated twice in the NVAF patients at 12-month intervals. During the first year, patients received neither antiplatelet agent nor anticoagulant; in the second year, aspirin (330 mg daily) was administered. The prevalence of lesions in the initial MRI was higher in NVAF patients (86.4%) than in sinus rhythm subjects (53.8%; p<0.001). After 12 months without aspirin, new lesions were seen in 20.6% of NVAF patients. The yearly occurrence of new lesions was decreased to 9.6% during the year of treatment with aspirin (p=0.014). Conclusions In patients with NVAF, abnormal lesions are frequently observed by MRI and aspirin treatment may be effective in preventing further small silent lesions. (Circ J 2004; 68: 410 -416)

Prevalence of Silent Cerebral Ischemia in Paroxysmal and Persistent Atrial Fibrillation and Correlation With Cognitive Function

“…Because of their selection within patients referring to a cardiovascular prevention outpatient clinic, the control group presented a moderate to high cardiovascular risk profile. Interestingly, the prevalence of SCI in subjects with a similar cardiovascular risk profile in previous experiences ranges from 53% to 58%, similar to that reported in the present study (12,13,31).…”

“…Few studies (9)(10)(11)(12)(13) have investigated the prevalence of SCI in patients with AF. The limited sample sizes, retrospective designs, and heterogeneity of patients and techniques (e.g.…”

Pretreatment with aspirin and etiology of first-ever ischemic stroke in young and middle-aged patients

“…Some indirect data regarding the influence of aspirin on SVD-related strokes can be found in the literature. Sato et al [15] found that aspirin may be effective in preventing small silent lesions, as demonstrated by MRI, in patients with non-valvular atrial fibrillation. Kapelle et al [16] examined vascular type of recurrent ischemic stroke in patients with supratentorial TIAs or non-disabling ischemic strokes who were treated with aspirin.…”

Asymptomatic Cerebral Microbleeds Seen in Healthy Subjects Have a Strong Association With Asymptomatic Lacunar Infarction

“…8,9 Moreover, it is well known that the incidence of clinical stroke is significantly higher in subjects with SLI than in those without.…”