Silent Cerebral Infarcts and Cerebral White Matter Lesions in Patients with Nonvalvular Atrial Fibrillation

Kobayashi, Akiko; Iguchi, Masahide; Shimizu, Satoru; Uchiyama, Shinichiro

doi:10.1016/j.jstrokecerebrovasdis.2010.09.004

Cited by 70 publications

(62 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kobayashi et al showed that the CHADS2 score was not associated with the number of SCI except in cortex/ subcortex, 8 and Gaita et al also reported that 60% of SCI patients had a CHA2DS2-VASc score ≤1. 20 If OAC can prevent SCI in AF patients, MRI screening in AF patients with CHA2DS2-VASc score ≤1 should be discussed.…”

Section: Potential Of Oac For Scimentioning

confidence: 99%

“…Kobayashi et al showed that a high rate of cortical/subcortical and deep white matter SCI was observed in patients with AF, which is thought to arise from a synergistic effect of microthrombi and hemodynamic abnormalities. 8 Sugioka et al reported that left atrial abnormalities and complex arch plaques diagnosed on transesophageal echocardiography were independent risk factors for SCI. 24 In a meta-analysis using general population data, SCI was an independent predictor of incident stroke (hazard ratio [HR], 2.08; 95% CI: 1.69-2.56; P<0.001).…”

Section: Silent Cerebral Infarction and Afmentioning

confidence: 99%

See 1 more Smart Citation

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients　― Meta-Analysis ―

Senoo

Kondo

Kobayashi

et al. 2018

Circ J

View full text Add to dashboard Cite

AF is also a well-established risk factor for dementia. For example, Liao et al reported a consistently higher rate of cognitive decline and risk of dementia in patients with AF. 11 These associations are partly due to the increased risk of clinical stroke in AF, but other mechanisms are likely to contribute, including the occurrence of SCI and microbleeds. 12 Current evidence is not sufficient to support a trend of increased prevalence of dementia in East Asia over the last few decades, but AF may contribute to dementia risk. We conducted a meta-analysis to compare the association of AF and SCI between East Asian and non-Asian patients. Methods Data SourcesPubMed were searched from their inception to 7 October 2017. No language restriction was applied. To ensure a comprehensive search of the literature, we also manually A trial fibrillation (AF) is the most common cardiac arrhythmia 1 and a major cause of stroke. The estimated global prevalence of AF is approximately 1-2%. 2 In Asia, the prevalence of AF has been reported to be slightly lower than that in Western populations. 3,4 Due to the much larger population in Asia, the burden of AF is estimated to be much greater in Asian than in Western populations. Indeed, it has been estimated that in 2050 there will be 72 million patients with AF in Asia, 4 more than double the combined number of patients from Europe and the USA. 1,5 Therefore, it is particularly important that AF is effectively managed in the ageing population of Asia.Silent cerebral infarction (SCI) is defined as the presence of cerebral infarction with the absence of corresponding clinical symptoms. In a recent meta-analysis, AF was associated with a more than 2-fold increased risk for SCI. 6 Several studies have reported an association between AF and increased risk of SCI in East Asian countries, 7-10 with the presence of SCI predicting subsequent clinically overt stroke. Thus, the prevalence of SCI and its effect as a risk factor for overt stroke are important considerations during the evaluation of AF.

show abstract

Section: Potential Of Oac For Scimentioning

confidence: 99%

Section: Silent Cerebral Infarction and Afmentioning

confidence: 99%

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients　― Meta-Analysis ―

Senoo

Kondo

Kobayashi

et al. 2018

Circ J

View full text Add to dashboard Cite

show abstract

“…However, there is very scant data concerning association of CHA 2 DS 2 VASc score and SCI. In one small study of 71 patients with AF Kobayashi et al showed that the number of cortical and subcortical SCI significantly correlated with CHADS 2 score [25].…”

Section: Prevalence Of Silent Cerebral Infarctions and Role Of Differmentioning

confidence: 98%

Clinical and echocardiographic predictors of silent cerebral infarctions in patients with persistent atrial fibrillation

Sychov

Бородай

Fedkiv

et al. 2014

Seminars in Cardiovascular Medicine

View full text Add to dashboard Cite

SummaryAim. The aims of the study were to evaluate prevalence of silent cerebral infarctions (SCI) and determine their clinical and echocardiographic predictors in patients with atrial fibrillation (AF). Patients and methods. In prospective cross sectional study we examined 134 patients with non-valvular AF. Clinical examination, laboratory tests, transoesophageal, transthoracic echocardiography and multislice computed tomography of the brain were performed for all patients. According to current guidelines, SCI was defined as imaging (≥3 mm) or neuropathological evidence of central nervous system infarction, without a history of acute neurological dysfunction attributable to the lesion. Results. Silent cerebral infarctions were detected in 34.3% (n = 46) of patients, and infarctions ≥ 15 mm (mean diameter 31.3 mm) were detected in 11.2% (n = 15) of patients. Superficial SCI were found in 12.7% and basal SCI in 21.6% of cases. In multivariate analysis low creatinine clearance < 90 ml/min was independently associated with small basal SCI (p = 0.04). In univariate analysis age ≥ 65 years was significantly associated with basal SCI, p = 0.004, but not with SCI ≥ 15 mm or superficial SCI. The results of multivariate analysis showed that CHA 2 DS 2 VASc score was an independent predictor of superficial SCI; low left atrial appendage velocity (LAAV) < 30 cm/s was independently associated both with SCI ≥ 15 mm (p = 0.03) and superficial SCI (p = 0.02). Conclusions. Large and superficial SCI were significantly and independently associated with low LAAV < 30 cm/s and other echocardiographic embolic risk factors and in case of absence of significant large arteries atherosclerosis may be considered as those of cardiac origin. Small basal SCI were associated with age and low creatinine clearance < 90 ml/min which was their independent predictor. CHA 2 DS 2 VASc score is useful for assessment of risk of cerebral infarctions even those without history of acute symptoms.

show abstract

“…We subdivided patients with AF according to cognitive status: without CI (SBT score 0-4), moderate CI (SBT score 5-9), and severe CI (SBT score [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. In these subsets of the population, we analyzed the available information on socio-demographic and clinical characteristics; length of hospital stay; in-hospital and 3-month mortality rates; and antithrombotic therapy at admission, discharge, and at 3-month followup.…”

Section: Cognitive Status and Anticoagulant Therapymentioning

confidence: 99%

“…Other evidence, and in particular a systematic review of the literature, suggests that AF may favor cognitive decline before and independently from an overt stroke [7,8]. Patients with persistent AF have been found to have smaller total brain and gray matter volume, more areas of silent cerebral ischemia and worse visual-spatial abilities than patients with paroxysmal AF [9][10][11]. These findings suggest a possible cumulative effect of AF on brain functions that worsens with time from first diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Corrao

Argano

Nobili

et al. 2015

European Journal of Internal Medicine

View full text Add to dashboard Cite

Silent Cerebral Infarcts and Cerebral White Matter Lesions in Patients with Nonvalvular Atrial Fibrillation

Cited by 70 publications

References 36 publications

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients　― Meta-Analysis ―

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients　― Meta-Analysis ―

Clinical and echocardiographic predictors of silent cerebral infarctions in patients with persistent atrial fibrillation

Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Contact Info

Product

Resources

About

Silent Cerebral Infarcts and Cerebral White Matter Lesions in Patients with Nonvalvular Atrial Fibrillation

Cited by 70 publications

References 36 publications

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients ― Meta-Analysis ―

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients ― Meta-Analysis ―

Clinical and echocardiographic predictors of silent cerebral infarctions in patients with persistent atrial fibrillation

Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Contact Info

Product

Resources

About

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients　― Meta-Analysis ―

Silent Cerebral Infarction in East Asian vs. Non-Asian Atrial Fibrillation Patients　― Meta-Analysis ―