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Silent Infarcts Found in Many Without Stroke History

Silent cerebral infarction risk associated with stroke risk profile, hypertension, atrial fibrillation

FRIDAY, June 27 (HealthDay News) -- More than 10 percent of subjects without a history of clinical stroke showed at least one silent cerebral infarction on MRI, according to research from a Framingham Offspring Study sample published online June 26 in the journal Stroke.

Rohit R. Das, M.D., of Boston University, and colleagues analyzed data from 2,040 subjects, mean age 62 years, who were free from stroke or dementia at the time of their brain imaging. Silent cerebral infarction (SCI) was considered to be an MRI infarct in people without a clinical stroke documented by the study's stroke surveillance team.

SCIs were found in 10.7 percent of participants, the investigators report. The majority (52 percent) were located in the basal ganglia. Factors associated with SCI were the Framingham Stroke Risk Profile score (odds ratio, 1.27), stage I hypertension (OR, 1.56), elevated plasma homocysteine in the highest quartile (OR, 2.23), and atrial fibrillation (OR, 2.16).

The prevalence of SCI in the study is cause for concern "because SCI has been related both to the risk of incident stroke and to cognitive impairment. The significant relationship between hypertension, elevated serum homocysteine, as well as carotid artery disease and prevalent SCI underscores the importance of current guidelines for the early diagnosis and prevention of hypertension and atherosclerosis and their risk factors. Atrial fibrillation is also associated with SCI, although our observational data cannot show if screening for and appropriately treating atrial fibrillation would reduce the population burden of SCI," the authors conclude.

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