Silent brain infarction and coronary artery disease in Japanese patients
H. Tanaka, K. Sueyoshi, M. Nishino, M. Ishida, R. Fukunaga and H. Abe
First Department of Internal Medicine, Osaka Rosai Hospital, Japan.
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.
