Cerebral microemboli were detected in 17% of patients with acute myocardial infarction and were significantly associated with stroke (P=0.01), reduced LV function, and LV thrombus.
Observational (n=100)
What is the frequency of cerebral microemboli detected by transcranial Doppler in patients with acute myocardial infarction, and do they correlate with risk factors and clinical embolic events?
Cerebral microemboli detected by transcranial Doppler are present in 17% of acute myocardial infarction patients despite antithrombotic therapy and correlate with reduced left ventricular function, LV thrombus, and clinical stroke.
Background and Purpose —This study was undertaken to determine the frequency of cerebral microemboli (high-intensity transient signals; HITS) detected by transcranial Doppler (TCD) in patients with acute myocardial infarction (AMI) and to relate them to the various putative risk factors and clinical embolic events. Methods —We investigated 112 consecutive patients within 72 hours of admission to an acute coronary care unit using TCD to monitor for cerebral microemboli. Twelve patients were excluded because of failure of ultrasound insonation. All patients had 2-dimensional echocardiograms within the study period. Results —HITS were detected in 17% of patients, with significantly higher frequency in patients with reduced (<65%) left ventricular (LV) ejection fraction ( P =0.019), akinetic LV segments ( P =0.002), and LV thrombus ( P =0.015). A marginally significant ( P =0.059) increase of HITS was found in patients with anterior AMI. Stroke was significantly more frequent in patients with cerebral microemboli ( P =0.01). Conclusions —HITS were detected in 17% of patients in spite of adequate antithrombotic therapy and were increased in patients with reduced LV function, akinetic myocardial segments, and LV thrombus. They were present in all 3 patients with stroke and may represent a predictor of clinical embolic events.
Nadareishvili et al. (Wed,) conducted a observational in Acute myocardial infarction (n=100). Transcranial Doppler (TCD) monitoring was evaluated on Frequency of cerebral microemboli (high-intensity transient signals; HITS). Cerebral microemboli were detected in 17% of patients with acute myocardial infarction and were significantly associated with stroke (P=0.01), reduced LV function, and LV thrombus.
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