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.
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.
Authors: Mariëlla E C Hassell; Robin Nijveldt; Yvo B W Roos; Charles B L Majoie; Martial Hamon; Jan J Piek; Ronak Delewi Journal: Nat Rev Cardiol Date: 2013-10-29 Impact factor: 32.419
Authors: Christopher M Reid; Elsdon Storey; Tien Y Wong; Robyn Woods; Andrew Tonkin; Jie Jin Wang; Anthony Kam; Andrew Janke; Rowan Essex; Walter P Abhayaratna; Marc M Budge Journal: BMC Neurol Date: 2012-02-08 Impact factor: 2.474
Authors: Ilaria Maestrini; Marta Altieri; Laura Di Clemente; Edoardo Vicenzini; Patrizia Pantano; Eytan Raz; Mauro Silvestrini; Leandro Provinciali; Isabella Paolino; Carmine Marini; Matteo Di Giuseppe; Tommasina Russo; Francesco Federico; Cristiana Coppola; Maria Pia Prontera; Domenico Maria Mezzapesa; Vincenzo Lucivero; Lucilla Parnetti; Paola Sarchielli; Maria Peducci; Domenico Inzitari; Giovanna Carlucci; Carlo Serrati; Carla Zat; Anna Cavallini; Alessandra Persico; Giuseppe Micieli; Stefano Bastianello; Vittorio Di Piero Journal: Stroke Res Treat Date: 2018-10-03