SILENT BRAIN INFARCTION AND CORONARY-ARTERY DISEASE IN JAPANESE PATIENTS

Objective.-Silent brain infarction is fairly common in the elderly, bu t predictive factors have not been definitively established. This stud y focuses attention on ischemic heart disease and cerebrovascular risk factors about the frequency of silent brain infarction. Design.-The e xistence of silent brain infarction, the extent of coronary artery ste nosis, and cerebrovascular risk factors of consecutive 92 case series with suspected ischemic heart disease were surveyed. Setting.-A hospit al for patients with ischemic heart disease. Patients.-Ninety-two cons ecutive Japanese patients with suspected ischemic heart disease were r ecruited. Main Outcome Measures.-All subjects were evaluated for coron ary atherosclerosis (number of coronary arteries with significant sten osis and Gensini score), the number of silent brain infarctions detect ed by computed tomography, the extent of carotid atherosclerosis as de termined by B-mode ultrasonography, and cerebrovascular risk factors. Results.-Patients with silent cerebral infarctions were older (66.2+/- 10.4 years) than those without such events (60.1+/-8.8 years) (P<.01). The extent of coronary atherosclerosis in patients with silent cerebr al infarctions was significantly greater than in those without such ev ents after adjustment for the effect of age (P<.001). The extent of ca rotid atherosclerosis and the percentages of individuals with hyperten sion, diabetes mellitus, a smoking habit, hypercholesterolemia, hypert riglyceridemia, and a low serum high-density lipoprotein cholesterol l evel did not differ between the groups with and without silent brain i nfarction. The frequency of silent brain infarction increased with the severity of coronary stenosis. Conclusion.-Coronary atherosclerosis a nd age were important risk factors for silent brain infarction.