Risk factors of silent cerebral infarcts in patients with acute coronary syndrome based on MRI findings

الملخص EN

Introduction the presence of silent brain infarcts increases the risk of subsequent stroke by two to four times in the general population, independent of cardiovascular risk factors.

the presence of silent brain infarcts doubles the risk of dementia, including Alzheimer’s disease.

aim of the work the degree of existence and the risk factors associated with silent cerebral infarcts (CSI) in patient with acute coronary syndrome (ACS) younger than 55 years old.

early detection might be helpful in optimizing treatment and prevention of further complications.

patients and methods : this study was prospective cross -sectional study included 40 patients < 55 years with ACS admitted at Sohag university hospitals : -with a definite diagnosis of ACS.

MRI (1.5 tesla) were done for all patients.

single cerebral infarction or more (and or) evidence of chronic white matter ischemia CWMI were considered as abnormal MRI findings.

results : patients were divided into two groups according to MRI findings : group 1 : -eight out of 40 patients (20%) with normal MRI.

group 2 : -32/40 patients (80%) with MRI findings of SCI and or chronic white matter ischemia.

there was non-significant difference between two groups as regards-age, sex, and ACS presentation, but there was significant difference as regards-body mass index (BMI and family history (FH) of vascular events.

incidence of hypertension and dyslipidemia were significantly higher in abnormal MRI group.

there was a non-significant difference between 2 groups as regards montreal cognitive score (MOCA).

abnormal MRI group had significant higher TG and LDL.

there was non-significant difference between 2 groups as regard echocardiographic criteria, coronary angiographic parameters and carotid doppler findings.

conclusion : more than two-third of patients with ACS present an abnormal MRI suggestive of atherosclerosis and ischemia.

risk factors include BMI, FH, dyslipidemia and hypertension.