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July 1993

Silent Brain Infarction and Coronary Artery Disease in Japanese Patients

Author Affiliations

From the First Department of Internal Medicine, Osaka (Japan) Rosai Hospital.

Arch Neurol. 1993;50(7):706-709. doi:10.1001/archneur.1993.00540070026009

• 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.