Incidence and predictors of silent embolic cerebral infarction following diagnostic coronary angiography

In-Cheol KimSeung-Ho HurNam-Hee ParkDong-Hwan JunYun-Kyeong ChoChang-Wook NamHyungseop KimSeong-Wook HanSae-Young ChoiYoon-Nyun KimKwon-Bae Kim
Dept. of Internal Medicine (내과학); Dept. of Thoracic & Cardiovascular Surgery (흉부외과학)
Issue Date
International Journal of Cardiology, Vol.148(2) : 179-182, 2011
Background: Coronary angiography (CAG) is an invasive diagnostic procedure, which could lead to procedure related complications. One of the well known post-procedural complications is cerebral embolic infarction with or without symptoms. Silent embolic cerebral infarction (SECI) has clinical significance because it can progress to a decline in cognitive function and increase the risk of dementia in the long term. The aim of this study was to detect the incidence and predictors of SECI after diagnostic CAG using diffusion-weighted magnetic resonance imaging (DW-MRI). Methods: A total of 197 patients with coronary artery disease who underwent DW-MRI for evaluation of intracranial vasculopathy before coronary artery bypass graft surgery were retrospectively enrolled in the present study. DW-MRI was performed within 48 h after diagnostic CAG. SECI was diagnosed as presence of focal bright high signal intensity in DW-MRI. Patients were divided into groups according to presence/ absence of SECI (+ SECI vs.− SECI, respectively). The clinical and angiographic characteristics were analyzed and independent predictors were evaluated. Results: Of the 197 patients, SECI occurred in 20 patients (10.2%) after diagnostic CAG. Age, female gender, frequency of underlying atrial fibrillation, extent of coronary disease, and fluoroscopic time during diagnostic CAG were not different between the + SECI and − SECI groups. Left ventricular ejection fraction was significantly lower in the + SECI group than in the − SECI group (45.9±8.5% vs. 51.4±13.1%, p=0.014) and performance rate of internal mammary artery (IMA) angiography was significantly higher in the + SECI group compared with the − SECI group (85% vs. 37.2%, pb0.001). By multivariate analysis, performing IMA angiography was the only predictor of SECI (OR=14.642; 95% CI=3.201 to 66.980, p=0.001). Conclusions: The incidence of SECI after diagnostic CAG was not infrequent. Diagnostic CAG with IMA angiography may increase the risk of SECI.
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1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Thoracic & Cardiovascular Surgery (흉부외과학)
Keimyung Author(s)
김인철; 허승호; 조윤경; 남창욱; 김형섭; 한성욱; 김윤년; 김권배; 박남희; 최세영
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