Key result
Silent brain infarction affects ~35% of patients with CAD, exceeding rates in stroke and PAD.
Why the study?
What is the prevalence of silent brain infarction in patients with systemic vascular disease?
Meta-Analysis
What is the prevalence of silent brain infarction in patients with systemic vascular disease?
Patients with systemic atherothrombotic disease are at an increased risk for silent brain infarctions, highlighting the systemic nature of vascular disease and a potential need for aggressive risk factor management.
Answers are grounded in this paper and cite their sources.
Silent brain infarcts affect up to 35% of coronary disease patients; extends recognition of systemic vascular burden while leaving optimal screening strategies open.
OBJECTIVE: To determine the prevalence of asymptomatic brain ischaemic in the presence of vascular disease in other arterial territories. DESIGN: Studies up to January 2011 were identified through comprehensive search strategies. Arcsine transformation for meta-analysis was used to calculate the standardized mean difference (SMD) and 95% confidence intervals (CI). SETTING: A systematic review and meta-analysis were performed. PARTICIPANTS: For each study, the proportion of patients positive for SBI in the presence of other systemic vascular disease was extracted and analyzed. MAIN OUTCOME MEASURES: Using a random-effects model, a pooled effect estimate interpreted as a percentage prevalence of disease was calculated. RESULTS: SBI in the presence of acute ischaemic stroke was found in 23% (SMD 0.99; P < 0.001; 95% CI 0.88-1.10); a 35% prevalence was found in patients with coronary artery disease (SMD 1.26; P < 0.001; 95% CI 0.95-1.58); and a 14% prevalence in patients with peripheral artery disease (SMD 0.48; P < 0.002; 95% CI 0.42-0.54), although the data-set in the latter is smaller. CONCLUSIONS: Patients with systemic vascular disease are at an increased risk of silent brain infarction.
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Slark et al. (2012) conducted a meta-analysis in Systemic vascular disease. Systemic vascular disease (coronary artery disease, acute ischaemic stroke, or peripheral artery disease) was evaluated on Prevalence of silent brain infarction in patients with coronary artery disease (SMD 1.26, 95% CI 0.95-1.58, p=<0.001). The prevalence of silent brain infarction was 35% in patients with coronary artery disease, 23% in acute ischaemic stroke, and 14% in peripheral artery disease.
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