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Atrial fibrillation doubles silent cerebral infarct risk


 

FROM ANNALS OF INTERNAL MEDICINE

References

Atrial fibrillation is associated with a more than twofold increase in the risk of silent cerebral infarctions, even in patients with no history of symptomatic stroke, a systematic review and meta-analysis has found.

The analysis of 11 studies involving 5,317 adults with atrial fibrillation (AF) but no history of stroke or prosthetic valves showed a significant increase in the risk of silent cerebral infarctions (odds ratio, 2.62), independent of whether their atrial fibrillation was paroxysmal or persistent, according to meta-analysis published online Nov. 3 in the Annals of Internal Medicine [doi:10.7326/M14-0538].

“Although SCIs [silent cerebral infarctions] do not present with acute stroke symptoms, they have been reported to be associated with more than three- and twofold increases in the risk for symptomatic stroke and dementia, respectively,” wrote Dr. Shadi Kalantarian and colleagues from the Institute for Heart Vascular and Stroke Care and Massachusetts General Hospital.

“Consequently, the higher prevalence of SCI in patients with AF may put this population at a greater risk for cognitive impairment, future stroke, and disability.”

The study was funded by the Deane Institute for Integrative Research in Atrial Fibrillation and Stroke, Massachusetts General Hospital, and the Harvard Catalyst and the Harvard Clinical and Translational Science Center. Two authors declared grants and personal fees from private industry.

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