Risk for 'Silent Stroke' Doubles with Atrial Fibrillation

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Risk for 'Silent Stroke' Doubles with Atrial Fibrillation
Risk for 'Silent Stroke' Doubles with Atrial Fibrillation

HealthDay News -- Atrial fibrillation may more than double the risk of silent cerebral infarction, results of a metaanalysis indicate. 

"Patients with atrial fibrillation are at higher risk of developing silent stroke," Shadi Kalantarian, MD, MPH, a resident at the Yale School of Medicine in New Haven, Conn., told HealthDay

Atrial fibrillation (AF) was associated with silent cerebral infarction (SCI) in patients with no history of symptomatic stroke (odds ratio, 2.62; 95% CI 1.81-3.80), independent of AF type (paroxysmal versus persistent), the researchers reported in Annals of Internal Medicine.

Previous studies have found that silent strokes are associated with a more than three-fold increase in the risk for symptomatic stroke and a two-fold increase in the risk for dementia, Kalantarian said.

For the current study, she and colleagues reviewed 11 previously published reports that looked at the association between atrial fibrillation and SCI in a total of 5,317 patients (five using MRI, four using CT, and two using autopsy). The two autopsy studies were deemed low quality and were excluded from the analysis. 

Overall, 4,407 patients were included in the final analysis (505 with AF; 3,902 without AF). Among those patients, 230 with AF (45.5%) and 610 without AF (15.63%) had an SCI. When the analysis was restricted to studies that met at least 70% of the maximum possible quality score, the results did not change significantly (odds ratio, 3.06; 95% CI 2.24-4.19).

"The higher prevalence of silent strokes in patients with atrial fibrillation may put this population at a higher risk for mental impairment, future stroke, and disability," Kalantarian said.

References

  1. Kalantarian S et al. Ann Intern Med. 2014;161(9):650-658.
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