Koroner arter hastalarında sessiz beyin infarktı sıklığı ve risk faktörleri

Abstract

SUMMARY The Prevalence Of Silent Brain Infarcts Among Pateints With Coronary Heart Disease The aim of this study was to determine the prevalence of silent brain infacts (SBI) by cranial magnetic resonance imaging (MRI) among patients elder than 40 years of age with a definite diagnosis of coronary artery disease confirmed by coronary angiography. Another aim was to evaluate the relationships between several risk factors, sociodemographic features and SBI. Seventy-one patients ( 48 male, 23 female) aged ranging from 43 years to 76 years ( mean 57.9 ±9.1) were included in this study. All cases had been hospitalized to Cardiology inpatient unit of Dicle University Faculty of Medicine with a preliminary diagnosis of myocard infarction or angina pectoris and received a definite diagnosis of coronary heart disease after coronary angiography. All patients underwent a detailed systemic and neurological examination and a detailed form including information about sociodemographic features and, vascular and non-vascular risk factors was completed for each patient. Detailed cardiac evaluation, routine laboratory examinations including complete blood count, blood glucose, lipid blood levesl and other parameters, electrocardiography, chest radiography and echocardiography were also performed. All patients were scanned with cranial MRG and carotid doppler ultrasonography one week after coronary angiography and the results were noted. MRG results were evaluated by two different radiologists to find out the presence, localization and amount of SBIs. The results of this study showed that 28 of 71 patients (39.6%) had at least one SBI. All patients with SbPhad white matter hipenntensities in 1 2 weighted MRI jwher as 50% of them had additional gray matter hyperintensities in basal ganglias. 64Average age, involved number of coronary arteries, the prevalence of carotid artery stenosis were significantly higher among patients with SBI than patients without SBI. No significant differences were found between these two groups in terms of other vascular and non-vascular risk factors including hypertension, diabetes mellitus, blood lipid levels, alcohol use and smoking. As a conclusion, this study has showed that SBI prevalence increase parallel to the increase in involved coronary arteries, and age and presence of carotid artery stenosis, and that SBI is a common complication encountered in patients with coronary arterial disease. The most important factors in development of SBI were determined to be advanced age and atherosclerosis, and SBI could be a manifestation of the result of the atherosclerotic impact on small vessels. As some studies reported SBI as a predisposing condition or a risk factor to stroke development, all necessary actions should be taken and appropriate treatment should be given to avoid the development of stroke or other severe vascular pathologies. 65